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Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

Shiferaw MB, Hailu HA, Fola AA, Derebe MM, Kebede AT, Kebede AA, Emiru MA, Gelaw ZD - PLoS ONE (2015)

Bottom Line: The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20.Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results.Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

View Article: PubMed Central - PubMed

Affiliation: Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.

ABSTRACT

Introduction: Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS) strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48%) in Amhara region compared to the World Health Organization (WHO) estimate (70%). This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia.

Materials and methods: A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS) method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20.

Results: Among 201 laboratories enrolled in this study, 47 (23.4%) laboratories had major errors. Forty one (20.4%) laboratories had a total of 67 false negative and 29 (14.4%) laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results.

Conclusion: The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

No MeSH data available.


Related in: MedlinePlus

Performance of specimen quality, staining and smearing techniques among laboratories in West Amhara Region, 2014.
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pone.0138488.g001: Performance of specimen quality, staining and smearing techniques among laboratories in West Amhara Region, 2014.

Mentions: Of the 39725 slides rechecked blindly, 35110 (88.4%) slides had clean background, 33222 (83.6%) good staining and 31666 (79.7%) normal size. Good specimen quality, normal thickness and good evenness accounted 29138 (73.3%), 28673 (72.2%) and 28377 (71.4%), respectively. However, 183 (88.4%) laboratories did not fulfill the overall six indicators of smearing quality. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively (Fig 1).


Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia.

Shiferaw MB, Hailu HA, Fola AA, Derebe MM, Kebede AT, Kebede AA, Emiru MA, Gelaw ZD - PLoS ONE (2015)

Performance of specimen quality, staining and smearing techniques among laboratories in West Amhara Region, 2014.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4574440&req=5

pone.0138488.g001: Performance of specimen quality, staining and smearing techniques among laboratories in West Amhara Region, 2014.
Mentions: Of the 39725 slides rechecked blindly, 35110 (88.4%) slides had clean background, 33222 (83.6%) good staining and 31666 (79.7%) normal size. Good specimen quality, normal thickness and good evenness accounted 29138 (73.3%), 28673 (72.2%) and 28377 (71.4%), respectively. However, 183 (88.4%) laboratories did not fulfill the overall six indicators of smearing quality. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively (Fig 1).

Bottom Line: The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20.Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results.Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

View Article: PubMed Central - PubMed

Affiliation: Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.

ABSTRACT

Introduction: Reliable smear microscopy is an important component of Directly Observed Treatment Scheme (DOTS) strategy for TB control program in countries with limited resources. Despite external quality assessment is established in Ethiopia, there is lower TB detection rate (48%) in Amhara region compared to the World Health Organization (WHO) estimate (70%). This highlights the quality of smear microscopy needs to be evaluated. Therefore, the aim of this study was to assess the quality of sputum smear microscopy performance among health center laboratories in West Amhara region, Ethiopia.

Materials and methods: A cross sectional study was conducted from July 08, 2013 to July 07, 2014. Data were collected from 201 public health center laboratories using a structured questionnaire. Slides were collected based on Lot Quality Assurance Sampling (LQAS) method and rechecked blindly by trained laboratory technologists. The data were entered into EPI info V.7 and smear quality indicators and AFB results were analyzed by SPSS version 20.

Results: Among 201 laboratories enrolled in this study, 47 (23.4%) laboratories had major errors. Forty one (20.4%) laboratories had a total of 67 false negative and 29 (14.4%) laboratories had a total of 68 false positive results. Specimen quality, smear thickness and evenness were found poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively. Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) were correlated with false negative results whereas no previous EQA participation (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive results.

Conclusion: The performance of health facilities for sputum smear microscopy was relatively poor in West Amhara region. Hence, strengthening the EQA program and technical support on sputum smear microscopy are recommended to ensure quality tuberculosis diagnostic service.

No MeSH data available.


Related in: MedlinePlus