Validation of candidate smear microscopy quality indicators, extracted from tuberculosis laboratory registers

Van Deun, A; Zwahlen, M; Bola, V; Lebeke, R; Bahati, E; Lubamba, P; Rieder, H L (2007). Validation of candidate smear microscopy quality indicators, extracted from tuberculosis laboratory registers. International journal of tuberculosis and lung disease, 11(3), pp. 300-5. Paris: International Union Against Tuberculosis and Lung Disease IUATLD

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SETTING: Kinshasa Province, Democratic Republic of Congo. OBJECTIVE: To identify and validate register-based indicators of acid-fast bacilli (AFB) microscopy quality. DESIGN: Selection of laboratories based on reliability and variation in routine smear rechecking results. Calculation of relative sensitivity (RS) compared to recheckers and its correlation coefficient (R) with candidate indicators based on a fully probabilistic analysis incorporating vague prior information using WinBUGS. RESULTS: The proportion of positive follow-up smears correlated well (median R 0.81, 95% credibility interval [CI] 0.58-0.93), and the proportion of first smear-positive cases fairly (median R 0.70, 95% CI 0.38-0.89) with RS. The proportions of both positive suspect and low positive case smears showed poor correlations (median R 0.27 and -0.22, respectively, with ranges including zero). CONCLUSIONS: The proportion of positives in follow-up smears is the most promising indicator of AFB smear sensitivity, while the proportion of positive suspects may be more indicative of accessibility and suspect selection. Both can be obtained from simple reports, and should be used for internal and external monitoring and as guidance for supervision. As proportion of low positive suspect smears and consistency within case series are more difficult to interpret, they should be used only on-site by laboratory professionals. All indicators require more research to define their optimal range in various settings.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Zwahlen, Marcel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1027-3719

ISBN:

17352096

Publisher:

International Union Against Tuberculosis and Lung Disease IUATLD

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:54

Last Modified:

20 Dec 2014 23:36

PubMed ID:

17352096

Web of Science ID:

000244918500014

BORIS DOI:

10.7892/boris.22792

URI:

https://boris.unibe.ch/id/eprint/22792 (FactScience: 36608)

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