title: Quality of sputum smear microscopy in Taiwan.
abstract: OBJECTIVE
  Four mycobacteriology laboratories in northern Taiwan collected slides from their routine work for an international training course on quality assurance of sputum smear microscopy held from 19-27 August 2004 in Taipei. Rechecking of a random sample of these slides provided an opportunity to evaluate the quality of sputum smear microscopy in the collaborating laboratories.
  
  
  METHODS
  Participants used a systematic sampling method to choose 100 to 120 slides from a set of 600 to 800 slides for evaluating the quality of smear and rechecking. Recheckers were blinded to the microscopy results reported by the testing laboratories. Discordant slides were re-examined by a second rechecker in order to make the final decision.
  
  
  RESULTS
  A total of 433 slides were evaluated for smear quality. Of these 433 slides, 177 (41%) had proper smear size, 194 (45%) proper thickness and 212 (49%) proper staining. Rechecking of slides revealed that 2 of 4 laboratories had at least 1 high false-negative and 3 of 4 laboratories had at least 1 low false-negative result.
  
  
  CONCLUSIONS
  We conclude that: 1) the 2 laboratories with high false-negative results need a supervisory visit in order to determine the causes; and 2) the national tuberculosis program should direct more attention to the quality of sputum smear microscopy and develop a formal plan for external quality assessment of sputum smear microscopy in Taiwan.
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: Chen-Yuan
authors.initials: CY
authors.lastname: Chiang
authors.forename: Hans L
authors.initials: HL
authors.lastname: Rieder
authors.forename: Sang-Jae
authors.initials: SJ
authors.lastname: Kim
authors.forename: Kai-Man
authors.initials: KM
authors.lastname: Kam
authors.forename: David
authors.initials: D
authors.lastname: Dawson
authors.forename: Tao-Pin
authors.initials: TP
authors.lastname: Lin
authors.forename: Kwen-Tay
authors.initials: KT
authors.lastname: Luh
mesh_terms: D003581:Cytodiagnosis / Q000592:standards; D005188:False Negative Reactions; D006801:Humans; D008853:Microscopy; D013183:Sputum / Q000382:microbiology*; D014376:Tuberculosis / Q000175:diagnosis*