Journal des méthodes de diagnostic médical
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Assessing the Quality of Tuberculosis Laboratory Services in Selected Public and Private Health Facilities in Western Amhara, Ethiopia

Mulusew Andualem Asemahagn

Introduction: Quality of TB laboratory services in both public and private health facilities is a mandatory
component in detecting active pulmonary TB cases and treatment follow-up. Even though it is one of the key components of DOTs strategy, a very low TB detection rate (36%) in Ethiopia and 37.5 % in Amhara Region was observed. The quality of TB laboratory services was very low (6.8%) in Ethiopia.
Methodology: Institutional based cross sectional study was conducted among 60 randomly selected public and private TB laboratories in Western Amhara, Ethiopia. Data were collected by interviewing 120 laboratory personnel and 384 TB suspected patients, reviewing 270 patient records and panel testing among 20 laboratories. Data entered in to computer via Epi Info version3.5.4 for editing and analysed using SPSS vesrsion19. Findings at 95%. Confidence interval and p value<0.05 were considered as statistical significant.
Results: The presence of quality laboratory services in the study areas was reported by 53.0% of the study participants. Supportive supervision and timely feedback, internal and external quality assurance practices, equity in training and resource distribution were issues given less attention in the study areas. Poor documentation from record reviewing and about 10% false negative discordant report on panel testing were observed. Shortage and unfair distribution of inputs can compromise service quality by 79% and 76% (OR=0.21, CI=0.08-0.57and OR=0.24, CI=0.07-0.81) respectively. Patient’s age, sex, religion, residence & educational status were none significant on TB laboratory services satisfaction. Farmers were 2.25 [1.26-4.05] times satisfied on TB laboratory services than their counter parts.
Conclusion: About 53.2% patients reported the presence of quality TB laboratory services. Documentation and microscopic diagnosis or reading problems were observed from record reviewing and panel testing. Equity in inputs, training access, standard operational procedures, supervision, quality control activities, informing patients and checking sputum quality were most important determinants to improve the quality of TB laboratory services