Taimia Ayub, Saima Ayub, Saim Maqsood, Maryam Ayub, Ayub Ali.
TB Diagnostic Centers; a study of Quality Assurance of TB Diagnostic Centers Through Proficiency Testing in Lahore.
Professional Med J Jan ;25(5):740-3.

Introduction: Tuberculosis is the leading infectious cause of death and was declared as global emergency in 1993. Sputum smear microscopy is the gold standard for diagnosis of the pulmonary tuberculosis. Blinded rechecking of the slides and panel testing are WHO recommended methods for assuring the quality of the TB diagnostic centers. Period: Oct, 2014 to Dec, 2014. Objectives: To assess the quality of sputum microscopy at diagnostic centers through proficiency testing.To compare the performance of trained and untrained laboratory staff in terms of sputum microscopy. Study Design: Cross-sectional descriptive. Setting: Lahore District. Methodology: Blinded rechecking and panel testing was performed and data was collected with the help of checklists in all the 30 (75%) functional diagnostic centers of Lahore district. Results: Errors in reporting were found in 13 (43%) out of 30 diagnostic centers during the blinded rechecking. There was no error in the blinded rechecking in microscopy of 17 (68%) AFB microscopy trained lab workers, while all the 5 (100%) untrained lab workers committed error. Only 17 (56%) lab workers reported 80-100% slides correctly during the panel testing; a minimum acceptable level of skill, while 13 (44%) reported 40-60% slides correctly. One of the most striking findings of the study was the relation of training with the performance of lab workers. Conclusion: Untrained lab staff should immediately undergo standardized training for sputum smear microscopy and refresher training should be given to the trained lab workers to enhance their knowledge and skills.

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