Blinded rechecking of sputum smear microscopy performance in public health facilities in Tigray region, Northern Ethiopia: Retrospective cross sectional study

Weldemhret, Letebrhan; Hailu, Ataklti; Gebru, Goyitom Gebremedhn; Bekuretsion, Hadish; Alemseged, Gebreselassie; Gebreegziabher, Gebremicheal; Tesfahuney, Gebrhiwot; Berhe, Tesfaye; Legesse, Lemlem; Kalayu, Kelali; Tesfay, Menasbo Gebru; Mehari, Kibrti

doi:10.1371/journal.pone.0239342

Cited by 5 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study has shown that EQA-blind rechecking participation practice for AFB-Microscopy was 52.9% among Xpert® MTB/RIF testing health facilities. This finding is similar to the northern part of Ethiopia’s that showed participating decreased from time to time which indicates there should be a re-vitalization of the EQA-blind rechecking practice in the country [ 46 ]. Regarding the on-site supervision practice, on-site supervision was not well practiced in TB-culture laboratories (33.3%).…”

Section: Discussionsupporting

confidence: 69%

Quality assurance practices in tuberculosis diagnostic health facilities in Ethiopia

et al. 2022

View full text Add to dashboard Cite

Introduction The quality of tuberculosis laboratory services in health facilities is a mandatory component of detecting active pulmonary TB cases and treatment follow-up. However, ensuring the quality of laboratory test results is a concern. This study aimed to assess the quality assurance practices in the tuberculosis diagnostic health facilities of Ethiopia. Materials and methods A cross-sectional study was conducted from October 2018 to March 2019 at nine governmental TB-culture laboratories and 34 randomly selected GeneXpert® MTB/RIF (Xpert® MTB/RIF) testing health facilities in Ethiopia. Participating health facilities were interviewed and laboratory documents and records present since 2017 were observed. Prior to the data collection, training was given to the data collectors. Descriptive statistics were used to produce results and were presented with tables and graphs. Results From a total of 34 Xpert® MTB/RIF testing laboratories, 50% run Internal Quality Control (IQC) for Acid-Fast Bacillus (AFB) Microscopy and 67.6% had lot-to-lot verification of staining reagents. For the Xpert® MTB/RIF assay, a lot-to-lot verification of cartridge and method validation was performed only in 8.8%and 20.6% of Xpert® MTB/RIF testing laboratories respectively. All TB-culture laboratories included in the study ran negative control (start and end IQC) during TB-culture sample processing and performed lot-to-lot verification for Mycobacteria Growth Indicator Tube (MGIT) in 88.9% of TB-culture laboratories. External Quality Assessment (EQA) Proficiency Testing (PT) for AFB microscopy is practiced in 79.4% Xpert® MTB/RIF testing laboratories and 100.0% for the Xpert® MTB/RIF assay. TB-Culture PT participation practice among TB-culture laboratories was 88.9%. A major challenge for health facilities during PT participation was the AFB PT-sample transportation delay (40.7%) and the Xpert® MTB/RIF assay EQA-PT feedback missing (38.2%). Conclusion This assessment reveals that IQC for AFB microscopy, lot-to-lot verification, method validation, and equipment calibration were not well-practiced. The majority of TB diagnostic health facility laboratories had EQA-PT participation practice, but a significant gap in PT-sample transportation and missing feedback was identified.

show abstract

Section: Discussionsupporting

confidence: 69%

Quality assurance practices in tuberculosis diagnostic health facilities in Ethiopia

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In frequency of laboratory errors, six papers [18][19][20][21][22][23] were looked at specific major technical laboratory errors. Shiferaw et al, 18 showed that 47 of 201 (23.4%) laboratories in the study had major false positive and false negative errors in diagnosing tuberculosis.…”

Section: Frequency Of Laboratory Errorsmentioning

confidence: 99%

“…Similarly, Mekonen et al 19 showed that 20 of 55 (36.4%) health center laboratories had false positive and false negative results in diagnosing tuberculosis. In addition, Desalegn et al 20 Measuring with some indicators like smear size, specimen quality, smear thickness, smear evenness and smear cleanliness, Weldemhret et al 21 showed that the performance of sputum smear quality were 68%, 61, 64%, 62 and 66% respectively. On the other hand, Tadesse et al study 22 showed that 742 of 2606 (28.5%) hematology laboratory specimens in the study had different technical errors.…”

Section: Frequency Of Laboratory Errorsmentioning

confidence: 99%

Medical Laboratories Quality Management and Challenges in Ethiopia: A Systematic Review

Mesganaw¹,

Fenta²,

Hibstu³

et al. 2023

PLMI

View full text Add to dashboard Cite

Background: Although based on a single system, each laboratory should have their own quality management system, in Ethiopia, quality management systems in medical laboratories were introduced in 2009 with the aim of improving the quality of services. Objective: This review was designed to evaluate the status of quality management practice and challenges among medical laboratories in Ethiopia. Methods: A systematic qualitative review of the literature was made by searching the international electronic bibliographic database of PubMed (NML), web of science (TS), google scholar, African journals online (AJOL) and Cochrane Library. Results: Thirty-six full-text articles, which were published between 2010 and 2022, were included in this review. In this review, 33 of 36 (91.7%) studies showed that status of quality management practice in Ethiopian medical laboratories was limited. As a result, the quality of medical laboratories was inadequate. The main challenges were problems associated with laboratory professionals (35/ 36=97.2%), inadequate support from management bodies (21/36=58.3%), limited on-job training access (8 /36=22.2%) and high workload (5/36=13.8%). Conclusion:The status of quality management practice among medical laboratories in Ethiopia is limited. The main quality compromising factors were problems associated with laboratory professionals, inadequate support from management bodies, high workload, and limited on-job training access. Therefore, all responsible stakeholders should focus on ensuring Quality Management Systems and the system should be applied in all Medical laboratories. Only this will ensure the improvement of quality within medical laboratories across Ethiopia.

show abstract

“…A number of factors, including social disparities in health, a lack of qualified local healthcare providers, and inadequate healthcare infrastructure in resource-constrained and developing nations, pose obstacles to efforts to reduce or eradicate this communicable disease. Therefore, it is clear that creating cost-effective mechanisms is an extremely important issue for medical treatment ( 3 ). Early diagnosis, effective treatment (therapy) are important ways to reduce the rate of the spread of this communicable disease (TB).…”

Section: Introductionmentioning

confidence: 99%

“…Chest x-rays or smear microscopy are almost exclusively used methods for research on automated TB system diagnosis. In terms of usability, accessibility, and maintainability, the sputum smear microscopic detection method for tuberculosis is the gold standard ( 3 , 6 , 7 ). To the best of the author's current knowledge, there is no research work conducted to assess sputum smears quality or Tb detection and diagnosis using CNN, SVM, and KNN classifiers.…”

Section: Introductionmentioning

confidence: 99%

Sputum smears quality inspection using an ensemble feature extraction approach

Kiflie

Tufa²,

Salau³

2023

Front. Public Health

View full text Add to dashboard Cite

The diagnosis of tuberculosis (TB) is extremely important. Sputum smear microscopy is thought to be the best method available in terms of accessibility and ease of use in resource-constrained countries. In this paper, research was conducted to evaluate the effectiveness of tuberculosis diagnosis by examining, among other things, the underlying causes of sputum smear quality for Ethiopian states such as Tigray, Amahira, and Oromia. However, because it is done manually, it has its limitations. This study proposes a model for sputum smear quality inspection using an ensemble feature extraction approach. The dataset used was recorded and labeled by experts in a regional lab in Bahir Dar, near Felege Hiwot Hospital after being collected from Gabi Hospital, Felege Hiwot Hospital, Adit Clinic and Gondar Hospital, as well as Kidanemihret Clinic in Gondar. We used a controlled environment to reduce environmental influences and eliminate variation. All the data was collected using a smartphone (the standard 15) with a jpg file extension and a pixel resolution of 1,728 × 3,840. Prior to feature extraction, bicubic resizing, and ROI extraction using thresholding was performed. In addition, sequential Gaussian and Gabor filters were used for noise reduction, augmentation, and CLAHE was used for enhancement. For feature extraction, GLCM from the gray label and CNN from the color image were both chosen. Ultimately, when CNN, SVM, and KNN classifiers were used to test both CNN and GLCM features, KNN outperformed them all with scores of 87, 93, and 94% for GLCM, CNN, and a hybrid of CNN and GLCM, respectively. CNN with GLCM outperformed other methods by 0.7 and 0.1% for GLCM and CNN feature extractors using the same classifier, respectively. In addition, the KNN classifier with the combination of CNN and GLCM as feature extractors performed better than existing methods by 1.48%.

show abstract

Blinded rechecking of sputum smear microscopy performance in public health facilities in Tigray region, Northern Ethiopia: Retrospective cross sectional study

Cited by 5 publications

References 10 publications

Quality assurance practices in tuberculosis diagnostic health facilities in Ethiopia

Quality assurance practices in tuberculosis diagnostic health facilities in Ethiopia

Medical Laboratories Quality Management and Challenges in Ethiopia: A Systematic Review

Sputum smears quality inspection using an ensemble feature extraction approach

Contact Info

Product

Resources

About