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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Sputum smear microscopy: Evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings
Journal of Clinical Microbiology, Volume 46, No. 3, Year 2008
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Description
Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories. Copyright © 2008, American Society for Microbiology. All Rights Reserved.
Authors & Co-Authors
van Rie, Annelies
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Fitzgerald, Daniel W.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Kabuya, Georges
Congo
National Reference Laboratory
van Deun, Armand
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Tabala, Martine
Democratic Republic Congo, Kinshasa
Universite de Kinshasa
Jarret, N.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Behets, Frieda M.T.F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Bahati, Etienne R.
Congo
National Tuberculosis Program
Statistics
Citations: 60
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1128/JCM.01553-07
ISSN:
00951137
Research Areas
Health System And Policy
Study Approach
Systematic review
Study Locations
Congo