著者

藤木 明子

出版者

JAPANESE SOCIETY FOR TUBERCULOSIS

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.67, no.1, pp.19-26, 1992

被引用文献数

1

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Evaluation of sputum smear examination was carried out with smear slides stained by the Ziehl-Neelsen method, which were collected from Nepal, Yemen and the Philippines. The smear slides were checked macroscopically and microscopically according to the following points: 1) smear area size, 2) thickness of smear, 3) evenness of smear, 4) decolourizing condition by Ziehl-Neelsen stain, 5) smear cleanness, 6) presence of cells in sputum and 7) smear reading accuracy by cross-checking.<BR>As the result of smear slide evaluation, it was concluded that proper sputum specimens have been smeared but smears were generally too thin and contaminated with too many dirts.<BR>Agreement rate of the slide reading in Nepal, Yemen and the Philippines were 73%, 90% and 88% respectively. Disagreement cases were concentrated in the subtle number of acid fast bacilli or (±) and (+) results. The cause of disagreement might be attributed to contamination with debris, deposit etc., which hinderd reading or were misread as acid-fast bacilli.<BR>Some improvement should be considered to eliminate the dirts, such as filtration of carbol fuchsin solution, preparation of proper quantity of carbol fuchsin solution to be consumed within three months, mixing the fuchsin stock solution and 5% carbol solution just before use, rinsing the mouth before sputum collection, usage of clean sputum container and slides, and smearing and drying of the slides within clean environment.<BR>However, in many developing countries there are many difficulties for facilities, equipments, system and management. Some of these difficulties may be solved by the efforts of laboratory side but some are beyond the limits of their efforts. Under such circumstance, there should be limitation in keeping and maintaining the quality of the examination.<BR>When evaluation or quality check of smear examination is attempted, the quality must be defined taking such background conditions into consideration.