Performance of Tuberculosis Smear Microscopistson Fluorescent stained microscopy among Health facilities of Eastern Region of Oromia, Ethiopia
| dc.contributor.advisor | Desta Kassu | |
| dc.contributor.advisor | Sisay Abay | |
| dc.contributor.author | Nebi Aman | |
| dc.date.accessioned | 2020-05-21T13:51:59Z | |
| dc.date.accessioned | 2023-11-06T08:56:32Z | |
| dc.date.available | 2020-05-21T13:51:59Z | |
| dc.date.available | 2023-11-06T08:56:32Z | |
| dc.date.issued | 2019-06 | |
| dc.description.abstract | Background:Tuberculosis (TB) is an infectious disease caused mainly by the bacillusMycobacterium tuberculosis and it remains a major public health problem. Globally 10.0 peoplewere ill and 1.3 million died of tuberculosis in 2017/18.In resource limited settings, tuberculosisdiagnosis relies on sputum smear microscopy with many variables affecting the sensitivity andspecificity.Tuberculosis is considered as a “global emergency” by the World HealthOrganization (WHO). Fluorescence microscopy (FM) can improve performance of microscopyand with the new light emitting diode (LED), technologies could be appropriate for peripheralsettings. The WHO defines External Quality Assessment (EQA) as a system for objectivelychecking a laboratory’s performance using an external agency or facility. EQA participation isassociated with improved laboratory performance over time and is a requirement for accreditation.However, many professionals in Sub-Saharan countries including Ethiopia are unable toeffectively implement quality improvement programs and many laboratories in Ethiopia remainwithout an accredited clinical laboratory. Objective: To assess the Performance of TB Smear Microscopistson fluorescent stained microscopy among Health facilities of Eastern Region of Oromia, Ethiopia, 2018. Methods: Afacility based cross sectional study design was conducted on 57 government Healthfacilitiesin Eastern Oromia Regional State from September to December 2018. The study wasincluded 57 governmental health facilities (42 health centers and 15 hospitals). Panel slides wereprepared and validatedat Adama Public Health Referral and Research LaboratoryCentrecustomized checklist were used to conduct on site supervision and slides were collectedfor Random Blinded Re-checking by Lot Quality Assurance Sampling Data were collected usingthe three external quality assessment methods.DataTechniques. Datawaswereentered into EPIInfo version 7 and transported to SPSS version 21.0 for analysis. The percentof agreements,differences and different types of errors were calculated. The Sensitivity, Specificity, PPV, NPVof smear reading by TB smear Mmicroscopist was calculated. The strength of an agreementamong between participant readers and the reference readers were assessed using kappastatistics. Results: In this study, the overall achievements during onsite evaluation were 62.7% and the overall agreement in reading among smear between mMicroscopists and Reference readers were92.21%92.21 %( kappa=0.755),which was good agreement.Overallagreement. OverallSensitivity and Specificity of detecting TB-FM bacilli were 90.54% and 94.03% respectively.The overall errors for panel test were 185(9.3%) which indicates25(1.26%) major errors,160(8.04%) minor errors. The overall Sensitivity, Specificity, PPV and NPV for blindedrechecking were 93.755.1%, 99.608%, 96.151.67% and 99.3547% respectively. Conclusionsand Recommendation: The overall performance of panel testing and randomblinded re-checking were satisfactory for this study but the overall facilities assessment resultsfor on-site evaluation were (62.53%)this need more effort to improve the performance.ErrorsBesides, the total errors committed were 9.3% and majority of them were minor errors andthe presence of this errorscommitted areare alarming for TB control program and due attentionshould be given for FM EQA method since the method is applied recently and not familiarizedas that of ZN method. This study recommended that, much effort should be made by laboratoryprofessionals need to up-grade their educational level to maximize the levelofagreement.method. Adama Public Health Referral and Research Laboratory Center and recheckinglaboratories should give correctiveactionssuchas,consistentrefreshmenttrainingandregularsupportivespervisionsaspertheEQAguidelinesand further researches should also beconducted. | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/21274 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Abeba University | en_US |
| dc.subject | ExternalQualityAssessment,TuberculosisAssessment, Tuberculosis and ,FluorescenceMicroscopy. | en_US |
| dc.title | Performance of Tuberculosis Smear Microscopistson Fluorescent stained microscopy among Health facilities of Eastern Region of Oromia, Ethiopia | en_US |
| dc.type | Thesis | en_US |