Proficiency and associated factors of laboratory professionals in sputum smear microscopy at selected peripheral public and private diagnostic laboratories in Ethiopia: cross-sectional study

埃塞俄比亚部分基层公立和私立诊断实验室的实验室人员痰涂片显微镜检查能力及其相关因素:横断面研究

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Abstract

BACKGROUND: In countries with a high prevalence of TB, such as Ethiopia, direct sputum smear microscopy remains the most cost-effective tool for diagnosing patients with infectious tuberculosis and monitoring their progress on treatment. However, poor-quality sputum microscopy services may lead to the failure to detect persons with active tuberculosis and may cause unnecessary anti-TB treatment for non-TB cases. Proficiency level is the percentage agreement between participants'readings and the reference panel results. The aim of this study was to assess proficiency and associated factors of laboratory professionals in sputum smear microscopy for acid-fast bacilli at selected peripheral public and private diagnostic laboratories in East Gojjam Zone, Northwest Ethiopia, in 2023. METHOD: An institutional-based cross-sectional study design was conducted from March 2023 to June 2023 at selected peripheral public diagnostic laboratories in East Gojjam Zone. 65 laboratory professionals were selected randomly from 41 peripheral public diagnostic laboratories in the study area. A validated questionnaire and 10 panel slides were used as data collection tools. The panel consisted of 5 pre-stained and 5 unstained slides. Data were entered and analyzed using the Statistical Package for Social Sciences software (SPSS version 20). P values less than 0.05 were considered statistically significant when looking for associations between dependent and independent variables. RESULT: The overall proficiency level of laboratory professionals in tuberculosis smear microscopy was 81.92% with 95% CI [78.46-85.38]. Previous TB smear microscopy training, work experience, and institution of education had a significant association with the overall performance of laboratory professionals in TB smear microscopy. CONCLUSION: The overall TB smear microscopy performance level of laboratory professionals at peripheral diagnostic laboratories in Ethiopia, was satisfactory, indicating a good level of competence. However, notable technical errors related to smear reading and reporting were observed. Thus, higher education institutions, especially private institutions, and the Zonal Health Department, should implement educational and training interventions to address the identified gaps and ultimately contribute to the national TB control program.

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