Quality Assessment Of Tuberculosis Laboratory Diagnosis In Selected Health Facilities Of Public Private Laboratories In Oromia Regional State

In the new Millennium, the quality of TB laboratory diagnosis in both public andrnprivate health facilities was often a direct reflection of the success of TB control programmesrnand a key component of the DOT strategy, yet it was one of the most neglected components ofrnthese programmes.rnObjective: To assess the quality of TB Laboratory Diagnosis in selected public & private HealthrnFacilities in Oromia Region.rnMethodology: Crossectional survey design was conducted out in 60 randomly selected public &rnprivate TB laboratories between 3rd January –12 th May 2011, in purposively selected 3 zones ofrnOromia Region. Sixty TB laboratory department heads were interviewed, 270 patients recordsrnwere reviewed, 384 TB laboratory clients were interviewed and panel testing for 20 laboratoryrntechnicians were done.Odd ratios and logistic regression were employed to see if any associationrnexits among the three quality parameters. Data were entered and analyzed using SPSS versionrn15.0 software and findings at 95% Confidence interval and p value of 0.05 were used forrnstatistical significance.rnResult: The study shows that staff training is a neglected issue in most private TB laboratoriesrnwhich are separated structurally from NTP, high false negative discordant rate of AFB result,rnweak supervision mechanism, and lack of checking the quality of sputum sample. Higherrnproportions of patients visited the TB laboratories were dissatisfied with lack of respect from thernproviders. Statistically significant association was observed between structure and processrnquality (OR =2.9(1.46-5.7; P=0.01) and between process and output quality parametersrn(OR=3.2(3.13-10; P=0.02).rnConclusion and Recommendations :The quality of TB laboratory diagnosis in both public andrnprivate TB laboratories in Oromia region were poor in that laboratory technicians training wasrnnot satisfactory, high false negative discordant rate of AFB result and the pattern of supervisionrnwas weak and unplanned. So mechanisms of improving the different stages of TB laboratoryrndiagnosis especially staff training, displaying and follow smear preparation and sticking to thernNational TB laboratory manual were strongly recommended.

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