Quality Control of Sputum Smear Examination Is Crucial in TB Case-finding
Training of microscopist including on-the-spot training
Routine checking for quality control
Keep all slides examined at the local microscopic center.
Routinely check all positive slides and 1/10 random sample of negative slides by experts of the reference laboratories.
Why Early Case Detection Is Needed?
Delay in case detection causes
(1) Increase of those infected from the case
(2) Worsening the prognosis of the case: Risk of immediate death by advanced TB or chronic pulmonary failure
Delay in Passive Case-finding
Factors Causing Delay in TB Case-finding
Patient's delay: Not visiting health facilities in appropriate time after the appearance of symptoms
Ignorance on TB symptoms
Neglect of symptoms
Inconvenient access to health facilities
Worry for cost of visiting doctors
Worry to be diagnosed as having TB
Motivation of patient himself and/or of family members or close friend for early visit to health facilities is needed
Doctor's delay: Not applying appropriate technologies to diagnose TB in appropriate time
Ignorance on TB
Not carrying out necessary investigations
Overlooking important findings
Neglect of patient's complaints
Intensification of under and post-graduate training for health professionals on TB is needed
