How better is random blinded re-checking results in Revised National TB Control Programme, India?

This study aims to determine the number and types of errors and the sensitivity among rechecked slides

From:: Department for International Development
Published: 16 October 2015

Country:: India
Document Type:: Journal Article
Theme:: Health
Authors:: Sharath, B.N., Kumar, A, Ranjini, R, Anand, S

Abstract

Introduction

In India, the Revised National Tuberculosis Control Programme (RNTCP) is being implemented adopting the World Health Organization Directly Observed Treatment, Short-Course (WHO DOTS) strategy since 1997. Sputum smear microscopy is the basis for diagnosis of tuberculosis under the programme. For diagnosis of TB, sputum microscopy is performed by trained laboratory technicians (LT) at designated microscopy centres (DMCs) using Ziehl-Neelsen staining technique.

Background

RNTCP is implementing the External Quality assurance (EQA) and Random blinded re-checking (RBRC) as one of its important component. This nationwide study was conducted to determine

the number and types of RBRC errors
the sensitivity and specificity among rechecked slides.

Materials and Methods

The study was based on the monthly RBRC reports submitted by ~13,000 designated microscopy centres (DMCs) across the country under routine programmatic settings in 2010. The DMCs reports were compiled at district, state and national level.

Results

A total of 11, 89,564 slides were rechecked from 11,039 DMCs. Of which 99.5% of rechecked slides did not have any errors. The sensitivity and specificity of the rechecked slides had 98% sensitivity and 100% specificity.

Conclusion

RBRC is the crucial component of EQA and the results from the programme are found to be satisfactory. Based on the study findings, the earlier value of 80% sensitivity used for calculation of annual sample size for RBRC has been increased to 90% sensitivity. The annual RBRC sample size for DMCs has been increased by 1.5–2 folds.

This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)

Citation

Sharath BN, Kumar A, Ranjini R, Anand S, Sundaram H, Singh SK, Kumar P. (2015) How better is random blinded re-checking results in Revised National TB Control Programme, Indian Journal of Medical Microbiology. 2015 Oct-Dec; 33(4): 572-5. doi: 10.4103/0255-0857.167318