Quality Assessment of Tuberculosis Laboratory Diagnosis in Selected Health Facilities of Public & Private Laboratories in Oromia Regional State
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Date
2011-05
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Addis Abeba Universty
Abstract
In the new Millennium, the quality of TB laboratory diagnosis in both public and
private health facilities was often a direct reflection of the success of TB control programmes
and a key component of the DOT strategy, yet it was one of the most neglected components of
these programmes.
Objective: To assess the quality of TB Laboratory Diagnosis in selected public & private Health
Facilities in Oromia Region.
Methodology: Crossectional survey design was conducted out in 60 randomly selected public &
private TB laboratories between 3rd January –12 th May 2011, in purposively selected 3 zones of
Oromia Region. Sixty TB laboratory department heads were interviewed, 270 patients records
were reviewed, 384 TB laboratory clients were interviewed and panel testing for 20 laboratory
technicians were done.Odd ratios and logistic regression were employed to see if any association
exits among the three quality parameters. Data were entered and analyzed using SPSS version
15.0 software and findings at 95% Confidence interval and p value of 0.05 were used for
statistical significance.
Result: The study shows that staff training is a neglected issue in most private TB laboratories
which are separated structurally from NTP, high false negative discordant rate of AFB result,
weak supervision mechanism, and lack of checking the quality of sputum sample. Higher
proportions of patients visited the TB laboratories were dissatisfied with lack of respect from the
providers. Statistically significant association was observed between structure and process
quality (OR =2.9(1.46-5.7; P=0.01) and between process and output quality parameters
(OR=3.2(3.13-10; P=0.02).
Conclusion and Recommendations :The quality of TB laboratory diagnosis in both public and
private TB laboratories in Oromia region were poor in that laboratory technicians training was
not satisfactory, high false negative discordant rate of AFB result and the pattern of supervision
was weak and unplanned. So mechanisms of improving the different stages of TB laboratory
diagnosis especially staff training, displaying and follow smear preparation and sticking to the
National TB laboratory manual were strongly recommended.
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Keywords
Quality Assessment of Tuberculosis Laboratory Diagnosis