Main Article Content
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 hospital