Abstract
Aims: To evaluate the present status of microbiology laboratory by comparing the test results of investigator with that of laboratory staff for sputum for Acid Fast Bacilli (AFB) withZiehl-NeelsenStaining (Z-N Staining) at primary and secondary level andto assess the present status of a microbiology laboratory for sputum for Acid Fast Bacilli (AFB) withZiehl-NeelsenStaining (Z-N Staining) at tertiary level. Material and Methods: Type of study : Cross sectional, descriptive type of study. Place of study: Department of Microbiology of Dhaka Medical College,Narsingdi Sadar Hospital,Narsingdi,PolashUpzilla Health Complex ,Polash, Narsingdi andDOTS centers. Duration of study: From July, 2007 to June,2008 Method of sampling: Non probability, purposive and convenient sampling Sample Size: Sputum for AFB: 300 sputum samples were collected for detection of AFB by direct Z-N staining, Z-N staining after bleach centrifugation and Auramine phenol staining before implementing SOP. After following SOP 150 sputum samples were collected and tested in direct Z-N method. Results: In the present study, before SOP out of 100 sputum smear at each level, discrepancy was found in 3% cases at primary level, 2% cases at secondary level and 1% case at tertiary level.After following SOP out of 50 sputum smear at each level, discrepancy was reduced to 2% cases at primary level and no discrepancy was found at secondary and tertiary level. Conclusion: Each laboratory must have SOP for laboratory testing to set the minimum acceptable standard for every test in order to improve and maintain the quality of laboratory services. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9824 BJMS 2012; 11(1): 51-56
Highlights
According to International Organization for Standards (ISO), quality is defined as totality of the characteristics of a product or service that make it suitable for the purpose for which it is intended[1]
Sample Size: Sputum for Acid Fast Bacilli (AFB): 300 sputum samples were collected for detection of AFB by direct Z-N staining, Z-N staining after bleach centrifugation and Auramine phenol staining before implementing standard operating procedure (SOP)
Before SOP, out of 100 sputum smear prepared from new TB suspects at primary level laboratory, 14 were smear positive and 86 were smear negative by the investigator
Summary
According to International Organization for Standards (ISO), quality is defined as totality of the characteristics of a product or service that make it suitable for the purpose for which it is intended[1]. Microscopy of sputum smear by bleach centrifugation methods (with 5% sodium hypochlorite solution) for concentration of the organisms is an important steps in the laboratory diagnosis of PTB using Ziehl-Neelsen staining and significantly increase the positivity of smear negative specimen. An attempt has been made to assess the quality of some tests such assputum for AFB in Ziehl-Neelsen staining in some microbiology laboratories at primary, secondary and tertiary level with the aim to improve the quality of those tests after preparing and implementing SOP for those tests. Table-IV shows that in the results of smear microscopy in direct Ziehl-Neelsen method, discrepancy was found in 3 cases at primary level, 2 cases at secondary level and 1 case at tertiary level before SOP. Table-V shows that out of 300 sputum smear at all level, 42(14%) were smear positive by ZiehlNeelsen method, 46(15.33%) were smear positive by fluorescence microscopy and 58(19.33%) were smear positive by Ziehl-Neelsen method after bleach centrifugation by the investigator
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