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.
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 and dirty smears were correlated with
false negative results whereas no previous EQA participation was associated with false positive results.
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.
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