APHA
Back to Annual Meeting
APHA 2006 APHA
Back to Annual Meeting
APHA Scientific Session and Event Listing

Positive effect of intensifying supportive supervision of AFB smear laboratories in Tbilisi, Georgia

Nina S. LeGrand and Luc Janssens, MD, DTM. Georgian Branch, Medical Service Corporation International, 3a Sarajishvili street, apt # 1, Tbilisi, Georgia, +995 32 44 18 30, luc.msci@caucasus.net

Medical Service Corporation International (MSCI) is assisting the National TB Program of Georgia. AFB Smear laboratory is one of the pillars of the DOTS strategy, but is often overlooked by the physicians that are running TB-control programs in developing countries. As a result of the neglect, the quality of AFB Microscopy suffers, which, in turn, leads to even less trust, and thus more neglect, thereby causing a vicious cycle. Blind rechecking of the smears is NTP's main Quality Control tool. However, our experience has shown that sputum sample collection and quality of smear preparation are often deficient. Some forging has also been encountered. A more hands-on approach was used to detect such problems: Intensive Supportive Supervision; Observation of daily laboratory practices; Improved rechecking of slides; Detailed feedback. As a result, smear quality was improved and discordance in blind rechecking reduced, leading to: Improved teamwork based on, both, trust in the results and the understanding of the central role of AFB microscopy in diagnosis and treatment of TB; Improved status of the laboratory technician in the TB control team. Our experience shows that supervisory visits should be: a) done regularly b) lengthy enough to observe all key activities c) documented in a report, showing findings and recommending corrective actions d) followed up to explore if recommendations were implemented

Learning Objectives:

Keywords: Quality Improvement, Tuberculosis

Presenting author's disclosure statement:

Any relevant financial relationships? No

Tuberculosis: Implementing Simple Approaches in High Burden Populations

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA