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Improving sputum microscopy services for the diagnosis of tuberculosis in Peru and Bolivia

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Show simple item record Siddiqi, K. en_US Newell, J. N. en_US Van der Stuyft, P. en_US Gotuzzo, E. en_US Torrico, F. en_US Van Deun, A. en_US Walley, J. en_US 2007-12-06T14:43:36Z 2007-12-06T14:43:36Z 2007 en_US
dc.identifier.issn 1027-3719 en_US
dc.identifier.other ITG-H3A en_US
dc.identifier.other ITG-M6A en_US
dc.identifier.other HEALTH en_US
dc.identifier.other U-EPID en_US
dc.identifier.other MICRO en_US
dc.identifier.other U-MYCOB en_US
dc.identifier.other JIF en_US
dc.identifier.other ABSTRACT en_US
dc.identifier.other MULTI en_US
dc.description.abstract SETTING: Sixteen primary care health centres in Peru and Bolivia. OBJECTIVES: To assess the utilisation of microscopy services in Peru and Bolivia and determine if clinical audit, a quality improvement tool, improves the utilisation of these services. DESIGN: We estimated the percentage of patients with suspected tuberculosis (TB) in whom sputum microscopy was effectively utilised in Peru and Bolivia over two 6-month periods before and after a clinical audit intervention that included standards setting, measuring clinical performance and feedback. RESULTS: Before the intervention, only 31% (95%CI 27-35) of TB suspects were assessed with sputum microscopy in Peru. In Bolivia, 30% (95%CI 25-35) underwent at least two sputum microscopy examinations. After clinical audit, the availability of sputum microscopy results improved by respectively 7% (95%CI 1-12, P < 0.05) and 23% (95%CI 15-30, P < 0.05) over 2 years in Peru and Bolivia. CONCLUSIONS: Despite World Health Organization recommendations that all TB suspects should undergo sputum microscopy before treatment, results are available for further assessment for only one third. This is a potentially serious obstacle to TB case detection. Clinical audit can bring some improvement. We recommend regular monitoring of effective utilisation of microscopy services and investigations to ascertain organisational and structural issues in their uptake and use. en_US
dc.language English en_US
dc.publisher International Union Against Tuberculosis And Lung Disease
dc.subject Bacterial diseases en_US
dc.subject Tuberculosis en_US
dc.subject Case detection en_US
dc.subject Sputum smear microscopy en_US
dc.subject Quality improvement en_US
dc.subject Audit en_US
dc.subject Peru en_US
dc.subject Bolivia en_US
dc.subject America, Latin en_US
dc.title Improving sputum microscopy services for the diagnosis of tuberculosis in Peru and Bolivia en_US
dc.type Article en_US
dc.citation.issue 6 en_US
dc.citation.jtitle International Journal of Tuberculosis and Lung Disease en_US
dc.citation.volume 11 en_US
dc.citation.pages 665-670 en_US Paris
dc.citation.jabbreviation Int J Tuberc Lung Dis en_US

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