ปัจจัยที่มีความสัมพันธ์กับคุณภาพการตรวจวินิจฉัยเสมหะผู้มีอาการสงสัยป่วยเป็นวัณโรค ที่ห้องปฏิบัติการอ้างอิงชันสูตรวัณโรคแห่งชาติ สำนักวัณโรค กรมควบคุมโรค

Abstract

ABSTRACT

This is descriptive research whose objective is to study associated factors of quality to Tuberculosis diagnosis in suspected cases at the National Tuberculosis Reference Laboratory, Department of Disease Control. The data was collected between November 3 to December 31, 2008 from 394 persons who visited TB clinics for newly suspected Tuberculosis diagnosis by using the first result of sputum examination and a questionnaire. The data analysis used descriptive statistics to show percentage, mean, standard deviation and Chi-square test results.

The results of this study indicate that the agreement rate of the quality on Tuberculosis diagnosis of the suspected cases using 394 smear slide examinations between permanent officers (persons making the initial assessment) and controllers was 98.7%. The sputum examination showed that results not found by permanent officers on white acid fast bacilli were found by the controller to be 0.6% of cases. That is in the acceptable level grade of false negatives. The discrepancy between acid fast bacilli found by permanent officers to acid fast bacilli not found by the controller was 6.1%. This is unacceptable for the false positive slides. The knowledge and attitude about sputum collection of the suspected cases was not good. This affected the behavior these people in that they produced unsatisfactory sputum quality as the sputum was mixed with saliva and saliva alone 92.4% of cases. Most of the bad sputum quality was caused by thin and uneven smear slides. The results of macroscopic examination on items of thick and thin smear slides and evenness of the smears and the reading of AFB smears showed relation to quality on Tuberculosis diagnosis by microscope p value < 0.001. Thus hygiene should be taught to the users via the theory on knowledge, attitude and behavior for assessment success in the communication or relay. Permanent officers should be workshop for get experience.

Key words: Quality, diagnosis, sputum, microscopy