Mabaera B, Naranbat N, Dhliwayo P, Rieder H L
University of Zimbabwe, Harare, Zimbabwe.
Int J Tuberc Lung Dis. 2006 Sep;10(9):1030-5.
This study determined the number of slides required to identify one additional case of sputum smear-positive tuberculosis (TB) from the third smear. The study hypothesis was that not more than 100 and 75 slides, respectively, in Mongolia and Zimbabwe, need to be examined to find one additional case of TB with a third serial diagnostic sputum smear examination.
In a retrospective, record-based study, data were abstracted from TB laboratory registers from all 31 laboratories in Mongolia and 23 randomly selected laboratories in Zimbabwe using a uniform EpiData collection instrument.
A total of 52,909 records of examinees were available. In Mongolia, of 15 103 suspects, 1717 (11.4%) were positive. Of these, 0.7% were positive for the first time on the third smear examination. In Zimbabwe, of 25 693 suspects, 3452 (13.4%) were positive and 4.5% were positive only on the third smear examination. The expected number of slides required to detect one additional case on the third examination was 1153.3 for Mongolia and 132.6 for Zimbabwe.
The requirement of routine examination of three serial smears before declaring a suspect as a 'non-case' (of sputum smear-positive TB) will need to be reviewed in both Mongolia and Zimbabwe.
本研究确定了从第三次涂片鉴定出另外一例痰涂片阳性肺结核（TB）所需的涂片数量。研究假设是，在蒙古和津巴布韦，分别检查不超过100张和75张涂片，就能通过第三次连续诊断痰涂片检查发现另外一例结核病。
在一项基于记录的回顾性研究中，使用统一的EpiData收集工具，从蒙古所有31个实验室和津巴布韦随机选择的23个实验室的结核病实验室登记册中提取数据。
共有52909份受检者记录。在蒙古，15103名疑似患者中，1717人（11.4%）呈阳性。其中，0.7%在第三次涂片检查时首次呈阳性。在津巴布韦，25693名疑似患者中，3452人（13.4%）呈阳性，4.5%仅在第三次涂片检查时呈阳性。在第三次检查时检测出另外一例病例所需的预期涂片数量，蒙古为1153.3张，津巴布韦为132.6张。
在蒙古和津巴布韦，在将疑似患者宣布为“非病例”（痰涂片阳性结核病）之前，对连续三张涂片进行常规检查的要求都需要重新审视。
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