Hurtig A K, Pande S B, Baral S C, Porter J D, Bam D S
London School of Hygiene & Tropical Medicine, UK.
Int J Tuberc Lung Dis. 1999 Nov;3(11):1009-14.
To investigate the characteristics of private laboratories and the process of sputum examination for acid-fast bacilli (AFB).
A door-to-door survey of private laboratories in an urban municipality of Kathmandu valley was conducted during the first quarter of 1998. Semi-structured interviews were conducted with staff of 14/20 (70%) identified laboratories.
All 14 private laboratories conducted sputum examination for AFB. The majority (71%) of staff lacked special training for AFB examinations. Monocular microscopes were commonly used (36%). Reagents were prepared irregularly, without quality control, and kept for as long as they lasted, often up to 4-6 months (43%). Laboratory registers were usually present (86%), but lacked information on patient's address and the purpose of the test. A median of 12.5 slides per laboratory had been examined during the previous month (range 0-70). A total of 235 AFB slides were examined, of which 18 (7.7%) were reported as positive.
AFB examinations were widely available. Lack of training and quality control suggest a variable standard of AFB test results. It is recommended that the National Tuberculosis Programme (NTP) provide support and quality control to two to three (i.e., one for every 10) private laboratories in the area to secure private doctors' confidence in sputum testing.
调查私立实验室的特点以及痰涂片抗酸杆菌（AFB）检测流程。
1998年第一季度，对加德满都谷地一个城市行政区的私立实验室进行了挨家挨户的调查。对20家已识别实验室中的14家（70%）的工作人员进行了半结构化访谈。
所有14家私立实验室均开展了痰涂片抗酸杆菌检测。大多数（71%）工作人员缺乏抗酸杆菌检测的专门培训。单目显微镜使用普遍（36%）。试剂制备不规范，没有质量控制，且只要能用就一直保存，通常长达4至6个月（43%）。实验室登记册通常有（86%），但缺少患者地址和检测目的的信息。上个月每个实验室检查的玻片数量中位数为12.5张（范围0至70张）。共检查了235张抗酸杆菌玻片，其中18张（7.7%）报告为阳性。
抗酸杆菌检测广泛开展。缺乏培训和质量控制表明抗酸杆菌检测结果的标准参差不齐。建议国家结核病规划（NTP）为该地区两至三家（即每10家有一家）私立实验室提供支持和质量控制，以确保私人医生对痰检的信心。
