埃塞俄比亚复查实验室结核病涂片显微镜检查人员的绩效评估

Performance evaluation of tuberculosis smear microscopists working at rechecking laboratories in Ethiopia.

作者信息

Asrat Habtamu, Kebede Abebaw, Abebe Abnet, Meaza Abyot, Hailu Getinet, Desale Adinew, Gashu Andargachew, Kassa Wondwossen, Mekonnen Tesfaye, Abose Ebisea, Girmachew Feven, Yenealem Dereje, Mulugeta Achamyeleh, Ayana Gonfa, Desta Kassu

机构信息

Ethiopian Public Health Institute, Addis Ababa, Ethiopia.

Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Afr J Lab Med. 2017 Apr 21;6(1):590. doi: 10.4102/ajlm.v6i1.590. eCollection 2017.

DOI:10.4102/ajlm.v6i1.590

PMID:28879154

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5523906/

Abstract

BACKGROUND

Tuberculosis is an infectious disease caused by the bacillus . According to the Ethiopian Federal Ministry of Health's 2013-2014 report, the tuberculosis case detection rate was 53.7%, which was below the target of 81% set for that year.

OBJECTIVE

This study assessed the performance of tuberculosis smear microscopists at external quality assessment rechecking laboratories in Ethiopia.

METHODS

A cross-sectional study was conducted at 81 laboratories from April to July 2015. Panel slides were prepared and validated at the National Tuberculosis Reference Laboratory. The validated panel slides were used to evaluate the performance of microscopists at these laboratories compared with readers from the reference laboratory.

RESULTS

A total of 389 external quality assessment rechecking laboratory microscopists participated in the study, of which 268 (68.9%) worked at hospitals, 241 (62%) had more than five years of work experience, 201 (51.7%) held Bachelors degrees, and 319 (82%) reported tuberculosis smear microscopy training. Overall, 324 (83.3%) participants scored ≥ 80%. Sensitivity for detecting tuberculosis bacilli was 84.5% and specificity was 93.1%. The overall percent agreement between participants and reference readers was 87.1 (kappa=0.72). All 10 slides were correctly read (i.e., scored 100%) by 80 (20.6%) participants, 156 (40.1%) scored 90% - 95%, 88 (22.6%) scored 80% - 85% and 65 (16.7%) scored below 80%. There were 806 (20.7%) total errors, with 143 (3.7%) major and 663 (17%) minor errors.

CONCLUSION

The overall performance of participants in reading the slides showed good agreement with the reference readers. Most errors were minor, and the ability to detect tuberculosis bacilli can be improved through building the capacity of professionals.

摘要

背景

结核病是由杆菌引起的一种传染病。根据埃塞俄比亚联邦卫生部2013 - 2014年的报告，结核病病例检出率为53.7%，低于当年设定的81%的目标。

目的

本研究评估了埃塞俄比亚外部质量评估复检实验室中结核病涂片显微镜检查人员的工作表现。

方法

2015年4月至7月在81个实验室进行了一项横断面研究。在国家结核病参考实验室制备并验证了标准玻片。使用经过验证的标准玻片来评估这些实验室的显微镜检查人员与参考实验室的阅片人员相比的工作表现。

结果

共有389名外部质量评估复检实验室的显微镜检查人员参与了该研究，其中268名（68.9%）在医院工作，241名（62%）有五年以上工作经验，201名（51.7%）拥有学士学位，319名（82%）报告接受过结核病涂片显微镜检查培训。总体而言，324名（83.3%）参与者得分≥80%。检测结核杆菌的敏感性为84.5%，特异性为93.1%。参与者与参考阅片人员之间的总体一致性百分比为87.1（kappa = 0.72）。80名（20.6%）参与者正确读出了所有10张玻片（即得分100%），156名（40.1%）得分90% - 95%，88名（22.6%）得分80% - 85%，65名（16.7%）得分低于80%。总共有806处（20.7%）错误，其中143处（3.7%）为重大错误，663处（17%）为轻微错误。