EVALUATION OF A STANDARDIZED RECORDING TOOL FOR SPUTUM SMEAR MICROSCOPY FOR ACID-FAST BACILLI UNDER ROUTINE CONDITIONS IN LOW-INCOME COUNTRIES

SETTING: Laboratories performing sputum smear microscopy for tuberculo sis in Benin, Malawi, Nicaragua and Senegal. METHODS: Analysis of comp uterized laboratory registers to ascertain workload, yield from serial smear examination, and demographic characteristics of examinees. RESU LTS: Data from more than 60 000 examinees in 42 laboratories showed th at the average number of smears examined per day ranged from 4 to 19 ( mean 6) per country. To find one case of tuberculosis, on average 21 s mears of suspects were examined (range 8 to 50). Of all cases with ult imately at least one positive result, 87% were already positive on the first examination. Demographic characteristics of cases differed cons iderably by country and gender. In 35 of 42 laboratories, males were m ore frequently found to be cases than females, and with increasing age an increasingly larger number of female than male suspects had to be examined to identify one case. CONCLUSIONS: This study demonstrates th e usefulness of a standardized recording system for results of acid-fa st microscopy in obtaining essential information for program managemen t and on demographic characteristics of persons presenting for examina tion.