title: Efficiency of a third serial sputum smear examination in the diagnosis of tuberculosis in Moldova and Uganda.
abstract: METHODS
  Twenty-four and 30 tuberculosis (TB) microscopy laboratories in Moldova and Uganda, respectively.
  
  
  OBJECTIVE
  To estimate the workload required to identify one additional case of TB with a third serial sputum smear examination.
  
  
  METHODS
  Retrospective laboratory register study to determine the prevalence and the incremental yield of TB cases from a third serial sputum smear examination among suspects in Moldova and Uganda, with the reciprocal of the product of these two fractions providing the number of examinations required to identify one additional TB case.
  
  
  RESULTS
  In Moldova, 9% (1141/12525) and in Uganda 20% (7280/36054) of suspects met the TB case definition with at least one positive sputum smear. The incremental yield from the third examination was 4% in Moldova and 3% in Uganda. To detect one additional TB case on a third smear, 273 examinations (95%CI 200-389) in Moldova and 175 (95%CI 153-222) in Uganda were thus required. This corresponded to an average of 11 days (8-16) and 7 days (6-9), respectively, to diagnose one additional case of TB.
  
  
  CONCLUSIONS
  In both countries, the third serial sputum smear examination was inefficient in diagnosing sputum smear-positive TB.
authors.affiliation: Department of Epidemiology, Case Western Reserve University, Cleveland, OH 44106, USA. achilles.katamba@case.edu
authors.forename: A
authors.initials: A
authors.lastname: Katamba
authors.forename: D
authors.initials: D
authors.lastname: Laticevschi
authors.forename: H L
authors.initials: HL
authors.lastname: Rieder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004526:Efficiency; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008966:Moldova / Q000453:epidemiology; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D014454:Uganda / Q000453:epidemiology; D016526:Workload