Tuberculosis Control Program: Implementing Proficiency Testing for TB Smear Microscopy in the Northern Province, South Africa - Guidelines for Provincial or Regional Settings

Rawlinson, Jakes
Other Authors: 
Mogale, Joyce
Publication Year: 
South Africa
Published by: 
Health Systems Trust

DOTS is being implemented in an attempt to address the resurgence of the TB epidemic and the emerging MDR TB epidemic in South Africa. DOTS focus on smear positive pulmonary TB patients, as they are the mainly responsible for feeding the epidemic in alliance with the HIV epidemic.

TB smear microscopy is the advocated method for diagnosis and to monitor progress and treatment outcomes. As the development of an affordable and rapid diagnostic kit for on site use in less developed and resource poor settings through the WHOs Diagnostic Initiative and other agents will probably not realise in the near future, TB smear microscopy for diagnosis and monitoring treatment outcomes is here to stay for the foreseeable future. To facilitate the implementation of DOTS, 13 new smear microscopy centres were established in the Northern Province in collaboration with the South African Institute of Medical Research since 1997. Extending the smear microscopy network without reducing the turn around times and quality assurance of the results is a relatively pointless exercise. Several activities were introduced to improve the quality of TB smear microscopy results, but as the quality of results was not assessed in a systematic way, whether this was achieved is not known.

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