Indirect external control of the quality of the sputum smear test slides of the tuberculosis program. Matanzas, 1997-2009

Abstract

The control of the sputum smear test quality is a system designed to improve the ability, efficiency and usage of the sputum smear test, as a diagnosis option and a monitoring, guarantying that the generated information is exact, reliable and reproducible. The objective of the current study was assessing the sputum smear test quality indicators in the laboratories of tuberculosis diagnosis at the municipal centers of hygiene and epidemiologic, of Matanzas, according to the parameters established in the program for controlling tuberculosis in Cuba. We took 100 % of the slides of the cases diagnosed with tuberculosis and 10 % of the negative slides in all the health institutions of the province where sputum smear tests are made. We carried out the quality control of 27 481 slides in the period from January 1997 to December 2009, according to the Handbook of procedures, of the National Program of Tuberculosis Control. Of the assessed slides, 27 444 (99.9 %) had concordant codifications, 3 slides (0.01) discrepant and 34 (0.12) discordant ones. The fault rate for all the false negative was 0,12 %; no false negative results were identified. These results suggest the quality of the staff making the tuberculosis sputum smear tests in the laboratories and we recommend do not neglect the continual supervision and maintaining a program  of technicians constant training  to continue improving the quality of the sputum smear test diagnosis in the province of Matanzas.