P004

1:Instituto de Investigaciones Científicas y Servicios de Alta Tecnología de Panama, Ciudad del Saber, Panamá; 2:Caja de Seguro Social, Colon, Panamá; 3:Ministerio de Salud, Colón, Panamá

Accurate and timely tuberculosis diagnosis is essential to reduce transmission and improve patient outcomes. In Panama, despite increased laboratory capacity, delayed diagnosis remains a challenge in high-burden regions. This study analyzed 400 tuberculosis patients diagnosed between 2021 and 2024 in Colón province using Ziehl-Neelsen and Auramine-Rhodamine staining, GeneXpert MTB/RIF Ultra, MGIT culture, and Genotype MTBDRplus. Diagnostic performance, turnaround time, bacillary burden, and treatment outcomes were evaluated. GeneXpert and fluorescence microscopy showed strong concordance (κ = 0.967) with median turnaround times of 1 day, while MGIT culture and Genotype testing were significantly slower (median 16 and 26 days, respectively). Most cases (64.8%) were diagnosed during hospitalization, with 72% presenting high bacillary load. Among 341 patients with outcome data, 58.8% were cured, 15.9% were lost to follow-up, and 10.3% died, with poorer outcomes linked to delayed diagnosis. Although the regional laboratory demonstrated excellent performance in microscopy and molecular diagnostics, the findings reveal critical gaps in early detection and timely resistance profiling. The results support the need to strengthen primary care-based screening, reduce diagnostic delays, and expand molecular diagnostic access in community settings to improve tuberculosis control in Panama and the Central American region.