Cargando…

Novel methodology to assess sputum smear microscopy quality in private laboratories

BACKGROUND: In South Asia, it is estimated that 80% of patients choose to attend a private facility for their healthcare needs. Although patients generally believe that the private-sector provides high quality services, private diagnostic laboratories are largely unregulated and little is known abou...

Descripción completa

Detalles Bibliográficos
Autores principales: Codlin, Andrew J, Javaid, Mona, Qazi, Fahad, Khan, Mishal S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519779/
https://www.ncbi.nlm.nih.gov/pubmed/23193964
http://dx.doi.org/10.1186/1471-2334-12-331
_version_ 1782252735426461696
author Codlin, Andrew J
Javaid, Mona
Qazi, Fahad
Khan, Mishal S
author_facet Codlin, Andrew J
Javaid, Mona
Qazi, Fahad
Khan, Mishal S
author_sort Codlin, Andrew J
collection PubMed
description BACKGROUND: In South Asia, it is estimated that 80% of patients choose to attend a private facility for their healthcare needs. Although patients generally believe that the private-sector provides high quality services, private diagnostic laboratories are largely unregulated and little is known about the accuracy of results provided. This study assesses the accuracy of sputum smear microscopy for pulmonary tuberculosis diagnosis in private laboratories operating in Karachi, Pakistan. A novel evaluation methodology was designed in which patient-actors submitted sputum specimens spiked with cultured Mycobacterium tuberculosis (Mtb) for testing such that laboratories were not aware that they were being assessed. METHODS: Smear-negative sputum specimens from Indus Hospital TB Program patients were collected and combined with an attenuated, cultured Mtb strain to create Mtb-spiked samples; for negative standards, no Mtb was added to the smear-negative sputum specimens. Seven of the largest private laboratories across Karachi were chosen for evaluation and were sent six Mtb-spiked and one Mtb-negative sputum specimens. Patient-actors pretending to be laboratory customers submitted these specimens to each laboratory for testing over a three day period. RESULTS: Only three laboratories accurately classified all the Mtb-spiked specimens which were submitted. A further three misclassified all the Mtb-spiked specimens as smear-negative, thus providing the ‘patients’ with false negative results. CONCLUSIONS: TB sputum smear microscopy services are highly variable across private laboratories and are often of extremely poor quality. Engagement, capacity building and rigorous monitoring of standards at private laboratories are of vital importance for the control of TB. Our findings, while specific for TB diagnostic tests, could be symptomatic of other tests performed in private laboratories and warrant further investigation.
format Online
Article
Text
id pubmed-3519779
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-35197792012-12-12 Novel methodology to assess sputum smear microscopy quality in private laboratories Codlin, Andrew J Javaid, Mona Qazi, Fahad Khan, Mishal S BMC Infect Dis Research Article BACKGROUND: In South Asia, it is estimated that 80% of patients choose to attend a private facility for their healthcare needs. Although patients generally believe that the private-sector provides high quality services, private diagnostic laboratories are largely unregulated and little is known about the accuracy of results provided. This study assesses the accuracy of sputum smear microscopy for pulmonary tuberculosis diagnosis in private laboratories operating in Karachi, Pakistan. A novel evaluation methodology was designed in which patient-actors submitted sputum specimens spiked with cultured Mycobacterium tuberculosis (Mtb) for testing such that laboratories were not aware that they were being assessed. METHODS: Smear-negative sputum specimens from Indus Hospital TB Program patients were collected and combined with an attenuated, cultured Mtb strain to create Mtb-spiked samples; for negative standards, no Mtb was added to the smear-negative sputum specimens. Seven of the largest private laboratories across Karachi were chosen for evaluation and were sent six Mtb-spiked and one Mtb-negative sputum specimens. Patient-actors pretending to be laboratory customers submitted these specimens to each laboratory for testing over a three day period. RESULTS: Only three laboratories accurately classified all the Mtb-spiked specimens which were submitted. A further three misclassified all the Mtb-spiked specimens as smear-negative, thus providing the ‘patients’ with false negative results. CONCLUSIONS: TB sputum smear microscopy services are highly variable across private laboratories and are often of extremely poor quality. Engagement, capacity building and rigorous monitoring of standards at private laboratories are of vital importance for the control of TB. Our findings, while specific for TB diagnostic tests, could be symptomatic of other tests performed in private laboratories and warrant further investigation. BioMed Central 2012-11-29 /pmc/articles/PMC3519779/ /pubmed/23193964 http://dx.doi.org/10.1186/1471-2334-12-331 Text en Copyright ©2012 Codlin et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Codlin, Andrew J
Javaid, Mona
Qazi, Fahad
Khan, Mishal S
Novel methodology to assess sputum smear microscopy quality in private laboratories
title Novel methodology to assess sputum smear microscopy quality in private laboratories
title_full Novel methodology to assess sputum smear microscopy quality in private laboratories
title_fullStr Novel methodology to assess sputum smear microscopy quality in private laboratories
title_full_unstemmed Novel methodology to assess sputum smear microscopy quality in private laboratories
title_short Novel methodology to assess sputum smear microscopy quality in private laboratories
title_sort novel methodology to assess sputum smear microscopy quality in private laboratories
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519779/
https://www.ncbi.nlm.nih.gov/pubmed/23193964
http://dx.doi.org/10.1186/1471-2334-12-331
work_keys_str_mv AT codlinandrewj novelmethodologytoassesssputumsmearmicroscopyqualityinprivatelaboratories
AT javaidmona novelmethodologytoassesssputumsmearmicroscopyqualityinprivatelaboratories
AT qazifahad novelmethodologytoassesssputumsmearmicroscopyqualityinprivatelaboratories
AT khanmishals novelmethodologytoassesssputumsmearmicroscopyqualityinprivatelaboratories