PMID- 26376438
OWN - NLM
STAT- MEDLINE
DCOM- 20160602
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 10
IP  - 9
DP  - 2015
TI  - Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health 
      Facilities in West Amhara Region, Ethiopia.
PG  - e0138488
LID - 10.1371/journal.pone.0138488 [doi]
LID - e0138488
AB  - INTRODUCTION: Reliable smear microscopy is an important component of Directly 
      Observed Treatment Scheme (DOTS) strategy for TB control program in countries 
      with limited resources. Despite external quality assessment is established in 
      Ethiopia, there is lower TB detection rate (48%) in Amhara region compared to the 
      World Health Organization (WHO) estimate (70%). This highlights the quality of 
      smear microscopy needs to be evaluated. Therefore, the aim of this study was to 
      assess the quality of sputum smear microscopy performance among health center 
      laboratories in West Amhara region, Ethiopia. MATERIALS AND METHODS: A cross 
      sectional study was conducted from July 08, 2013 to July 07, 2014. Data were 
      collected from 201 public health center laboratories using a structured 
      questionnaire. Slides were collected based on Lot Quality Assurance Sampling 
      (LQAS) method and rechecked blindly by trained laboratory technologists. The data 
      were entered into EPI info V.7 and smear quality indicators and AFB results were 
      analyzed by SPSS version 20. RESULTS: Among 201 laboratories enrolled in this 
      study, 47 (23.4%) laboratories had major errors. Forty one (20.4%) laboratories 
      had a total of 67 false negative and 29 (14.4%) laboratories had a total of 68 
      false positive results. Specimen quality, smear thickness and evenness were found 
      poor in 134 (66.7%), 133 (66.2%) and 126 (62.7%) laboratories, respectively. 
      Unavailability of microscope lens cleaning solution (AOR: 2.90; 95% CI: 
      1.25-6.75; P: 0.013) and dirty smears (AOR: 2.65; 95% CI: 1.14-6.18; P: 0.024) 
      were correlated with false negative results whereas no previous EQA participation 
      (AOR: 3.43; 95% CI: 1. 39-8.45; P: 0.007) was associated with false positive 
      results. CONCLUSION: The performance of health facilities for sputum smear 
      microscopy was relatively poor in West Amhara region. Hence, strengthening the 
      EQA program and technical support on sputum smear microscopy are recommended to 
      ensure quality tuberculosis diagnostic service.
FAU - Shiferaw, Melashu Balew
AU  - Shiferaw MB
AD  - Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.
FAU - Hailu, Hiwot Amare
AU  - Hailu HA
AD  - Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.
FAU - Fola, Abebe Alemu
AU  - Fola AA
AD  - Walter and Eliza Hall institute of medical research, Melbourne, Australia.
FAU - Derebe, Mulatu Melese
AU  - Derebe MM
AD  - Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.
FAU - Kebede, Aimro Tadese
AU  - Kebede AT
AD  - Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.
FAU - Kebede, Abayneh Admas
AU  - Kebede AA
AD  - Amhara Regional State Health Bureau, Bahir Dar, Ethiopia.
FAU - Emiru, Manamnot Agegne
AU  - Emiru MA
AD  - Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.
FAU - Gelaw, Zelalem Dessie
AU  - Gelaw ZD
AD  - Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia.
LA  - eng
PT  - Journal Article
DEP - 20150916
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Bacteriological Techniques/*standards
MH  - Clinical Laboratory Techniques/*standards
MH  - Cross-Sectional Studies
MH  - Ethiopia/epidemiology
MH  - Humans
MH  - Laboratories/*standards
MH  - Laboratory Proficiency Testing
MH  - Lot Quality Assurance Sampling
MH  - Microscopy
MH  - Mycobacterium tuberculosis/*isolation & purification
MH  - *Quality Control
MH  - Sputum/*microbiology
MH  - Tuberculosis/*diagnosis/epidemiology/microbiology
PMC - PMC4574440
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2015/09/17 06:00
MHDA- 2016/06/03 06:00
PMCR- 2015/09/16
CRDT- 2015/09/17 06:00
PHST- 2015/02/13 00:00 [received]
PHST- 2015/08/31 00:00 [accepted]
PHST- 2015/09/17 06:00 [entrez]
PHST- 2015/09/17 06:00 [pubmed]
PHST- 2016/06/03 06:00 [medline]
PHST- 2015/09/16 00:00 [pmc-release]
AID - PONE-D-15-06157 [pii]
AID - 10.1371/journal.pone.0138488 [doi]
PST - epublish
SO  - PLoS One. 2015 Sep 16;10(9):e0138488. doi: 10.1371/journal.pone.0138488. 
      eCollection 2015.