Evaluation of Same Day Diagnosis of TB Microscopy in Comparison to the Spotmorning-spot method and Knowledge, Attitude and Practice of Health Personnel towards the Use of the Same Day Diagnosis of TB in Selected Health Institution in Addis Ababa, Ethiopia.
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Date
2012-06
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Addis Abeba University
Abstract
Back ground: the need to collect serial sputum specimens over multiple patient visits results in a
protected diagnostic process with rates of patients with high rates of patient dropout. Recent
studies on SMS method of examination PTB reported that the first two specimens have high
smear positivity in line with this WHO changed its policy to minimize the number of sputum
specimens from three to two.
Objective: The main objective of this study was to evaluate the same day diagnosis of TB
microscopy in comparison to the spot-morning-spot methods and KAT of lab personnel, GP, HO
and Nurse to wards the use of the same day diagnosis of TB in selected health institutions in
Addis Ababa.
Material and method: Across sectional study were conducted in 16 conveniently selected
private clinics, governmental health centers, public hospitals and private hospitals, federal police
and armed force hospital from September – December 2012.All patients who were avail
themselves in the selected health institutions for the diagnosis of MTB and those health personal
who were worked in each health facility. The diagnosis was performed using ZN sputum smear
microscopy and light-emitting diodes fluorescent microscopy (LED-FM) technique. A structure
and pre-validate questionnaires was used to collect data for KAP survey. Chi-square was used to
assess the associations’ different variables of techniques and health personals KAP study.
Result: A total of 209 participant enrolled, 43(21%) were identified culture positive,39 (18.7%)
were detected by the same day approach and 40(19.1%) by the standard approach (p>0.05).on
the other hand LED-FM and ZN microscopy were identified 39(18.1%) and 48(23%)
respectively. Sensitivity was (88.4%) for ZN microscopy and (95.3%) for LED-FM, it was
(99.4%) and (95.9%) for specificity.
More over the mean and median knowledge, practice and attitude score of laboratory personal
about the same day diagnosis was 4.07, 5.96, 7.67 and 5, 5, 8 respectively. Majority
(61%),(73%) and (97%) of Laboratory personal had good knowledge, practice and positive
attitude while the mean and median knowledge score was 4.7 and 4 respectively, but the mean
and median attitude and practice was 6.65, 6.4 and 8.7 respectively .majority (57.7%),(63.4%)
and (72.4%) of other health personal had poor knowledge, positive attitude and good practice
respectively.
using same day approach together with LED-FM would increase the smear detection rate,
reduce work load, TAT, patient and health facility cost and transmission of TB. Hence, it is
essential to address the advantages and dis advantages of the conventional approaches, LED-FM
and same day diagnosis of TB to raise KAPs` of health personnel.
Therefore it is necessary to give in-service and off service training for health personnel towards
the use of LED-FM, conventional approach and the same day approach in the diagnosis of TB
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Keywords
TB,TB microscopy