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背景:肯尼亚,内罗毕市委员会胸科诊所。 目的:为确定痰涂片漏读是造成肯尼亚内罗毕涂阴结核病不相称增加的因素。 方法:对1997年10月至1998年11月之间履行地方规划规定的认为是涂阴肺结核的病人,进一步收取两个痰标本,在研究实验室进行萤光显微镜检查。 结果:在选入研究的163名成人病例中,55％为人类免疫缺陷病毒1型(HIV-1)血清学阳性,100名病人在收集和获得两次新的痰标本在研究实验室再检查之前,已有两个研究前的痰涂片检查。在这些人中,19名(19％)通过再次检查为痰涂片阳性和第二次再检查又有7名(7％)成为涂片阳性。 结论:由地方规划确定的认为是涂阴肺结核的病人中当仔细地两次重复痰涂片检查时有26％为涂片阳性,提示,在涂阴结核病中有高比例的漏读,这可能是由于结棱病负担太重而导致痰检查的过于迅速和欠精确。对固定技术人员的再培训和培训更多的技术人员可能减少漏读和增加涂阳结核病的检出。该发现也强调需要常规的质量保证。
Background: Nairobi City Board Thoracic Clinic, Kenya. OBJECTIVE: To determine whether sputum smear leakage is a disproportionate increase in smear-negative tuberculosis in Nairobi, Kenya. METHODS: Patients with smear-negative pulmonary tuberculosis who performed local planning between October 1997 and November 1998 were asked to further receive two sputum samples for fluorescence microscopy in the research laboratory. RESULTS: Of the 163 adult cases selected for the study, 55% were serologically positive for human immunodeficiency virus type 1 (HIV-1) and 100 were collecting and obtaining two new sputum specimens in a research laboratory retest Previously, there were two sputum smear tests before the study. Of these, 19 (19%) became smear-positive again by retesting positive for sputum smear and 7 (7%) for the second retest. CONCLUSIONS: Twenty-six percent of smear-positive patients in carefully scheduled sputum smear examinations were found to be smear-negative in patients with locally-smeared tuberculosis identified by the local program, suggesting a high percentage of missed-smears in smear-negative TB, which may Is due to knot edge burden is too heavy and lead to sputum examination is too rapid and less precise. Retraining and training fixed technicians More technicians may reduce missed readings and increase detection of smear-positive TB. This finding also emphasizes the need for routine quality assurance.