External quality control of the tuberculosis laboratory network of São Paulo state, Brazil
PDF (Português (Brasil))

Keywords

quality control
pulmonary tuberculosis
microscopy

How to Cite

1.
Pedro H da SP, Villela G, Coelho AGV, Nardi SMT, Silva RRF e, Galle LC, Shikama M de LM, Leite AR, Povinelli RF, Silva JO, Ferraz MHL, Ferrazoli L. External quality control of the tuberculosis laboratory network of São Paulo state, Brazil. Rev Inst Adolfo Lutz [Internet]. 2015 Oct. 2 [cited 2024 May 18];73(4):351-7. Available from: https://periodicos.saude.sp.gov.br/RIAL/article/view/33375

Abstract

The aim of this study was to evaluate the technical quality of acid-fast bacilli (AFB) smears procedure for tuberculosis (TB), which is performed in public and private laboratories (labs) affiliated to the Brazilian Healthcare System, and to report the results of the external quality assessment (EQA) performed in the TB laboratory network of State São Paulo. For such purpose, a retrospective descriptive study of EQA was conducted in 198 supervised labs for a two-year period (2009-2010). The correlation among the AFB smears results from the supervised labs and the supervisors was 99.4%; and the percentages of false-positive and false-negative results were 1.9% and 0.4 %, respectively. Comparing the smears performance between the public and private labs, the public labs showed higher quality (p-value<0.05). This study showed that 74.2 % of the evaluated labs were approved in the EQA, and that the private labs performance got low-ranking when compared to the public labs results. These findings reinforce the importance of conducting both the CQE programs for AFB smears performance and the technicians and professionals training program as this diagnostic assay is relevant and widely used in Brazil.
https://doi.org/10.18241/0073-98552014731626
PDF (Português (Brasil))

References

1. Barreira D, Grangeiro A. Avaliação das estratégias de controle da tuberculose no Brasil. Rev Saúde Pública. 2007; 41(supl 1):4-8.

2. Ministério da Saúde. Secretaria de Vigilância em Saúde. Programa Nacional de Controle da Tuberculose. Manual de recomendações para o controle da Tuberculose no Brasil. Brasília (DF): Ministério da Saúde; 2010.

3. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica. Manual nacional de vigilância laboratorial da Tuberculose e outras Micobactérias. Brasília (DF): Ministério da Saúde; 2008.

4. Ministério da Saúde. Secretaria de Vigilância em Saúde. Portaria nº 2.031/GM em 23 de setembro de 2004.Dispõe sobre a organização do Sistema Nacional de Laboratórios de Saúde Pública [Internet site]. Disponível [http://dtr2001.saude.gov.br/sas/PORTARIAS/Port2004/GM/GM-2031.htm]. Acesso 30 Maio 2011.

5. Ministério da Saúde. Fundação Nacional de Saúde. Tuberculose:guia de vigilância epidemiológica. Brasília (DF): Ministério da Saúde; 2002.

6. Lanata CF, Black RE. Lot quality assurance sampling techniques in health surveys in developing countries: advantages and current constraints. World Health Stat Q. 1991; 44:133-9.

7. Aziz MA. External quality assessment for AFB smear microscopy. Washington (DC): APHL; 2002.

8. Selvakumar N, Prabhakaran E, Rahman F, Chandu NA, Srinivasan S, Santha T, et al. Blinded rechecking of sputum smears for acid-fast bacilli to ensure quality and usefulness of re-staining of smears to assess false-positive errors. Int J Tuberc Lung Dis. 2003;7:1077-82.

9. Gilpin C, Kim SJ, Lumb R, Rieder HL, Van Deun A, Working Group on Sputum Smear Microscopy. Critical appraisal of current recommendations and practices for tuberculosis sputum smear microscopy. Int J Tuberc Lung Dis. 2007;11:946-52.

10. Kusznierz G F, Latini OA, Sequeira MD. Quality assessment of smear microscopy for acid-fast bacilli in the Argentine tuberculosis laboratory network, 1983-2001. J Tuberc Lung Dis. 2004;8:1234-41.

11. Vieira FD, Salem JI, Ruffino-Netto A, Camargo AS, Ferro e Silva RR, Moura LCC, et al. Methodology for characterizing proficiency in interpreting sputum smear microscopy results in the diagnosis of tuberculosis. J Bras Pneumol. 2008;34:304-11.

12. Rieder HL, Van Deun A, Kam KM, Kim SJ, Chonde TM, Trébucq A, et al. Priorities for tuberculosis technology services in Low-Income Countries. 2nd ed. Paris: International Union Against Tuberculosis and Lung Disease; 2007.

13. The Global Fund. Fighting Tuberculosis. The global tuberculosis epidemic [Internet site]. Available: http://www.theglobalfund.org/en/about/diseases/tuberculosis/. Accessed 14 Ago 2013.

14. Instituto Brasileiro de Geografia e Estatística. Cidades [Internet site]. Disponível: [http://cidades.ibge.gov.br/xtras/uf.php?lang=&coduf=35&search=sao-paulo]. Acesso 14 Ago 2013.

15. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33:159-74.

16. Galesi VMN, Santos LAR. Tuberculose: a cura em estado de alerta. Prática Hospital. 2004;6:67.

17. Imaz MS, Sequeira MD, Red de Laboratorios Provinciales de Tuberculosis en Argentina. Diagnóstico bacteriológico de la tuberculosis em Argentina: resultados de una encuesta nacional. Cad Saúde Pública. 2007;23:885-96.

18. Romero MRM, García G, Cardoso EM. Evaluación de los indicadores de calidad de la baciloscopía de tuberculosis en los laboratórios provinciales de diagnóstico de Cuba. Arch Venez Farmacol Ter. 2008;27:110-3.

19. Mundy CJF, Harries AD, Banerjee A, Salaniponi FM, Gilks CF, Squire SB. Quality assessment of sputum transportation, smear preparation and AFB microscopy in a rural district in Malawi. Inter J Tuberc Lung Dis. 2002;6:47-54.

20. Van Deun A, Portaels F. Limitations and requirements for quality control of sputum smear microscopy for acid-fast bacilli. Int J Tuberc Lung Dis. 1998;2:756-65.

21. Paramasivan CN, Venkataraman P, Vasanthan JS, Rahman F, Narayanan PR. Quality assurance studies in eight State tuberculosis laboratories in India. Int J Tuberc Lung Dis. 2003;7:522-7.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2015 Instituto Adolfo Lutz Journal

Downloads

Download data is not yet available.