RESUMEN
The human immunodeficiency virus (HIV) epidemic and dual infection of tuberculosis (TB) and HIV are now altering the role of chest radiography (CR) in TB control. The role has been gaining increasing importance, especially as HIV-associated TB and childhood TB are less likely to show positive smears. However, CR with poor image quality can cause misdiagnoses or require repeated examinations, wasting economic resources and exposing patients to unnecessary radiation. In order to improve the image quality of CR, the Tuberculosis Coalition for Technical Assistance (TBCTA) developed an assessment tool for CR categorized on the basis of six factors as “excellent,” “good,” “fair,” and “poor.” With the aim of disseminating the assessment tool, five-day international training sessions were held in Cambodia and Kenya in 2009. This field report summarizes the international training activities and documents the findings after the trainings.<BR>A total of thirty-four participants from 14 countries were trained and assigned to conduct an assessment upon their return. The results from nine countries showed that the quality of CR ranged from 90% excellent or good in Bangladesh to over 90% fair or poor in Afghanistan. Of 69 health facilities, only 4 apply more than 120kV and above. This is one of the considerable factors behind the sub-optimal quality of CR in these countries.
RESUMEN
<b><big>Introduction</big></b><br>As for the available healthcare services, there is a big gap not only between developed and developing countries but also those are not equally available even in a single country. In order to cope with geographical gaps of healthcare services in the Republic of Yemen, the improvement of accessibility to healthcare services is placed as priority of the 5-year plan of health development. However, analysis of health information in developing countries may not be easy because of the weak health statistics mechanism. The data from national TB control program may be considered as a possible way to analyze the geographical gaps and improve the tuberculosis case finding in developing countries.<br><b><big>Methods</big></b><br>The case detection rate of new smear positive tuberculosis patients in districts was calculated by using data from the latest population census in the Republic of Yemen. The calculated case detection rate was statistically analyzed with the factors such as availability of microscopy centre, population and the distance from provincial capital.<br><b><big>Results</big></b><br>The case detection rate of new smear positive tuberculosis patient is significantly different in the districts that have microscopy centre or more than 42,322 populations. The availability of the microscopy centre may be considered as the significant factor for achieving better case finding of new smear positive tuberculosis patients in the districts. Population of the districts where new smear positive tuberculosis patients found has been calculated as 74.1% of the total population. This calculation almost matches the target of the population that may be covered by the public health services according to the 5-year health development plan of the Ministry of Public Health.<br><b><big>Conclusions</big></b><br>The statistically analyzed data may provide a possible way to improve the national TB control program.