Abstrait

Assessment of Tuberculosis Laboratory Quality: A Multi Centre Descriptive Cross Sectional Study in Sidama Zone, Southern Ethiopia

Aregahegn Bekele Gelaye, Birhan Meshesha Hirut, Dawit Jember Tesfaye, Lopiso Desalegn Tirore

Background: Tuberculosis laboratories play an imperative role to achieve the global goal for case detection of smear-positive pulmonary cases. However, tuberculosis laboratories in a low resource setting face numerous quality bottlenecks and hence, achieving the desired case detection target would only be a dream unless continuous monitoring and quality improvement mechanisms are put in place. Therefore, the objective of this study was to assess the quality of tuberculosis laboratory at public health facilities, Sidama zone, southern Ethiopia. Method: A facility based descriptive cross-sectional study was conducted in fifty-six health facilities performing Acid-Fast Bacilli (AFB) microscopy. Data were collected using structured questionnaire and observation checklist. SPSS version 20.0 software was used for data entry and analysis. Descriptive summaries were used to describe the study variables. Results: The overall performance of the tuberculosis laboratories was 48.9%. The lowest score was recorded on training status (19.7%) and the highest score was recorded on biosafety and waste disposal (69.4%). Inadequate performance also identified in infrastructure (28.1%), Standard Operating Procedure’s (49.5%), reagents and equipment (43.5%), maintenance of microscope (42.9%), External Quality assessment (46.8%), internal quality control (25.6%) and data management (57.1%). Conclusion and recommendations: The present study revealed a number of underperformance in the quality of tuberculosis laboratories. To ensure sustainable preventive maintenance of microscope, attention should be given for training and deployment of personnel trained in biomedical equipment maintenance. Laboratory technician should filter Carbol-fuchsin before use and check the quality of stains and staining technique. Training of the laboratory technicians on quality assurance of microscopy would be a good first step to enhance Standard Operating Procedure practice of tuberculosis laboratories.