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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/2607

Title: Quality performance Evaluation of Laboratories on AFB smears Microscopy in Eastern Amhara Region, Ethiopia, 2011.
Authors: Mekete, Mulat
Advisors: Mr. Kassu Desta (BSc, MSc)
Mr. Getachew Belay (BSc, MSc)
Mr. Ibrahim Ali (BSc, MSc)
Keywords: Ethiopia
East Amhara
random blinded rechecking
Onsite evaluation
Panel testing
Copyright: Jun-2011
Date Added: 4-May-2012
Publisher: AAU
Abstract: Background: External quality assessment is the most effective method for evaluation of AFB diagnostic methods for tuberculosis. Blinded rechecking of AFB slides using lot quality assurance sampling methods is currently practiced in many DOTS centers. In addition panel testing and onsite supervision are critical components of standard EQA program that can assess the overall performance of microscopic centers. Objectives: This study aimed to evaluate the quality performance of laboratories in AFB smear microscopy and identifying TB slide positivity rate in peripheral diagnostic centers in Eastern Amhara Region. Material and method: A cross-sectional study in 21 peripheral diagnostic centers in Eastern Amhara region, was conducted from October 2010 to April 2011.A total of 799staind smears were randomly collected for rechecking. Ten slides of panel testing smear were sent out to 21 microscopic centers to evaluate reading, staining and reporting performance of individuals. Check lists were used to assess quality issues of laboratories. Tuberculosis registration books were used to determine slide positivity rate. Data were captured, cleaned and analyzed using SPSS version 17. X2 test, kappa values were used for comparison purpose. P value <0.05 was considerable to statistically significant. Results: Proficiency panel test score of 100 %, 80-95 %, 60 % was performed by 9, 11, 1 laboratories, respectively. Out of 799 randomly selected slides, 8.3 % and 8.6 % were reported to be positive for acid fast bacilli by the first and the second (regional) laboratory personnel, respectively. Overall, false reading was 1.6 % and the overall agreement was 98.4%. There is a slight difference among public and private microscopic centres in selected quality performance x2 (p value < 0.05). Annual PTB examinees were 6,212 in 2006 / 2007; 9537 in 2007 / 2008; 10499 in 2008 / 2009 and 13,086 in 2009 / 2010. while the positivity rate was 8.7, 9.9, 10.7 and 7.4 with respectively. The maximum positivity rate was between the ages of 15 and 34. Generally, positivity rate was 9.6 % among females and 8.4 % among males. Conclusion and recommendation: The overall performance of majority of microscopic centers is acceptable. The overall slide positivity rate (SPR) was 9 % and showed an increasing trend from 2006/ 2007- 2009/ 2010 with slight decline at the end of 2010. Continuous quality performance assessment of tuberculosis microscopic centers should be considered as part of DOTS program for proper diagnosis and management of tuberculosis in the region. This should include panel testing, blinded rechecking and onsite supervision of laboratories along with strengthening of public private partnership for tuberculosis control in the region.
URI: http://hdl.handle.net/123456789/2607
Appears in:Thesis - Medical Microbiology

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