RESUMO
Setting : The tuberculosis control programme in Khon Kaen province, North East Thailand.Objective : To develop a tool for supervisor to easily assess the quality of screening for tuberculosis suspects in peripheral health units.Methods : Field exploration, tool development and field testing by researchers and health professionals.Results : A tested supervisor tool measuring the proportion smear positive tuberculosis suspects and the proportions suspects with two and three smears examined, indicative for screening performance. Defined acceptable levels of performance and remedial action to be taken.Conclusion : The tool is simple to use by the supervisors, is acceptable to supervisees and stimulates to self assessment and improvement.Key words : tuberculosis, tool, supervision, screening, district hospital
RESUMO
Setting : Nineteen district hospital laboratories and a reference Zonal Tuberculosis control Centre laboratory in Khon Kaen, Thailand. Objective : To assess the performance of sputum smear examinations by peripheral laboratory technicians in their own work setting. Design : Exploratory study. 19 district hospital laboratories were asked to submit monthly a sample of sputum slides that were examined during 1990 and 1991. These slides were reexamined by a reference laboratory technician. The reading results were compared and the influence of slide preparation on the reading result was analyzed. Results : In a sample of 1057 slides the agreement in reading results between the reference and peripheral laboratories was 94% However, 39% of slides were not prepared well in sputum collection, smearing or staining. Among the slides with good sputum but with poor smearing or staining a significantly different proportion of positive slides were found compared with the well prepared slides when examined by the reference laboratory. The authors speculate that technicians in the district and reference laboratories make the same mistakes in reading these poorly prepared slides, so that a high agreement in results does not guarantee good performance. Conclusion : Not only agreement in reading results but also the proportion well prepared slides is and important indicator for peripheral laboratory performance. Keyword : tuberculosis, performance, sputum smear examination, district hospitalRequest for reprints :