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Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia

BACKGROUND: Using the Directly Observed Treatment-Short course (DOTS) program the World Health Organization’s global target was to detect 70% of new sputum-smear positive PTB cases. Smear positive PTB cases are more infectious than the smear negative cases. The TB case detection rate remains very lo...

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Autor principal: Mekonnen, Abiyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024114/
https://www.ncbi.nlm.nih.gov/pubmed/24885987
http://dx.doi.org/10.1186/1756-0500-7-295
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author Mekonnen, Abiyu
author_facet Mekonnen, Abiyu
author_sort Mekonnen, Abiyu
collection PubMed
description BACKGROUND: Using the Directly Observed Treatment-Short course (DOTS) program the World Health Organization’s global target was to detect 70% of new sputum-smear positive PTB cases. Smear positive PTB cases are more infectious than the smear negative cases. The TB case detection rate remains very low in Ethiopia, but there are increases in smear-negative PTB diagnosis which could be attributed to several factors including poor quality of sputum smear-microscopy. METHODS: A five years retrospective record review of data between September, 2007 and August, 2012 and an in-depth assessment of AFB staining practices of sputum smear using a standard checklist were made. The proportion of smear positive cases relative to overall Acid Fast Bacilli (AFB) screened was determined over a five year period to indicate the overall prevalence and the trend. Odds ratio with 95 percent confidence interval was calculated for categorical variables using multivariate Logistic Regression model to assess the strength of association. RESULT: A total of 1266 individuals’ data were reviewed. The majority of the study participants were male, 704 (55.6%), and rural residents, 690 (54.5%). The overall prevalence rate of smear positive PTB was 21.6%. Age categories between 15–24 and 25–34 years were independent predictors of smear positive PTB with adjusted odds ratio of 2.246 [95% CI (1.098-4.597)] and 2.267 [95% CI (1.107-4.642)], respectively. More males were affected by PTB than females with an adjusted odds ratio of 1.426 [95% CI (1.083-1.879)]. An in-depth interview with the respective laboratory chiefs showed that quality control measures for sputum smear microscopy were used at different levels of the testing activities; however, equipment function verification as a quality control measure was not accomplished regularly in all of the study hospital laboratories. CONCLUSION: The smear positive PTB case detection rate indicated in this study is significantly lower than the countries which met the 70% target of the World Health Organization. Lack of feedback mechanisms in the External Quality Assurance schemes of sputum smear microscopy render the opportunity for improvement difficult; Serial sputum examination showed a considerable rate of positivity in the second sputum sample when compared with the others.
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spelling pubmed-40241142014-05-18 Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia Mekonnen, Abiyu BMC Res Notes Research Article BACKGROUND: Using the Directly Observed Treatment-Short course (DOTS) program the World Health Organization’s global target was to detect 70% of new sputum-smear positive PTB cases. Smear positive PTB cases are more infectious than the smear negative cases. The TB case detection rate remains very low in Ethiopia, but there are increases in smear-negative PTB diagnosis which could be attributed to several factors including poor quality of sputum smear-microscopy. METHODS: A five years retrospective record review of data between September, 2007 and August, 2012 and an in-depth assessment of AFB staining practices of sputum smear using a standard checklist were made. The proportion of smear positive cases relative to overall Acid Fast Bacilli (AFB) screened was determined over a five year period to indicate the overall prevalence and the trend. Odds ratio with 95 percent confidence interval was calculated for categorical variables using multivariate Logistic Regression model to assess the strength of association. RESULT: A total of 1266 individuals’ data were reviewed. The majority of the study participants were male, 704 (55.6%), and rural residents, 690 (54.5%). The overall prevalence rate of smear positive PTB was 21.6%. Age categories between 15–24 and 25–34 years were independent predictors of smear positive PTB with adjusted odds ratio of 2.246 [95% CI (1.098-4.597)] and 2.267 [95% CI (1.107-4.642)], respectively. More males were affected by PTB than females with an adjusted odds ratio of 1.426 [95% CI (1.083-1.879)]. An in-depth interview with the respective laboratory chiefs showed that quality control measures for sputum smear microscopy were used at different levels of the testing activities; however, equipment function verification as a quality control measure was not accomplished regularly in all of the study hospital laboratories. CONCLUSION: The smear positive PTB case detection rate indicated in this study is significantly lower than the countries which met the 70% target of the World Health Organization. Lack of feedback mechanisms in the External Quality Assurance schemes of sputum smear microscopy render the opportunity for improvement difficult; Serial sputum examination showed a considerable rate of positivity in the second sputum sample when compared with the others. BioMed Central 2014-05-13 /pmc/articles/PMC4024114/ /pubmed/24885987 http://dx.doi.org/10.1186/1756-0500-7-295 Text en Copyright © 2014 Mekonnen; 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 credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Mekonnen, Abiyu
Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia
title Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia
title_full Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia
title_fullStr Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia
title_full_unstemmed Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia
title_short Smear-positive pulmonary tuberculosis and AFB examination practices according to the standard checklist of WHO’s tuberculosis laboratory assessment tool in three governmental hospitals, Eastern Ethiopia
title_sort smear-positive pulmonary tuberculosis and afb examination practices according to the standard checklist of who’s tuberculosis laboratory assessment tool in three governmental hospitals, eastern ethiopia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024114/
https://www.ncbi.nlm.nih.gov/pubmed/24885987
http://dx.doi.org/10.1186/1756-0500-7-295
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