title: Investigating the quality of expectorated sputum for tuberculosis diagnosis in Bolivia.
abstract: A low-power microscope-based cytological system to assess the quality of expectorated sputum provided for tuberculosis (TB) diagnosis was piloted in Bolivia. A total of 3688 samples were subjected to visual and cytological examination in nine laboratories: of these, 591 (16%) were misclassified by visual examination and 294 (8%) were found to be degraded. The degree of discordance varied between locations, and laboratories received a higher number of degraded specimens from isolated health clinics. Cytological assessment of sputum was found to be feasible and identified areas for improvement in the Bolivian diagnostic system for TB.
authors.affiliation: Pro Mundi Share Salut, La Paz, Bolivia.
authors.forename: P
authors.initials: P
authors.lastname: Hernández
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Punchak
authors.affiliation: Instituto Nacional de Laboratorios en Salud, La Paz, Bolivia.
authors.forename: M
authors.initials: M
authors.lastname: Camacho
authors.affiliation: Manson Unit, Médecins Sans Frontières, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Hepple
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: McNerney
mesh_terms: D001431:Bacteriological Techniques; D001838:Bolivia; D006801:Humans; D007753:Laboratories; D008853:Microscopy; D013048:Specimen Handling / Q000592:standards*; D013183:Sputum / Q000166:cytology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*