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地点:摩尔多瓦和乌干达分别有24和30个结核病(TB)显微镜检查实验室。目的:评价第3次痰涂片检查对确诊1例增加的TB病例所需的工作量。方法:采用实验室登记回顾性研究,通过第3次痰涂片检查确定TB患病率和增加的病例数,TB病例来源于摩尔多瓦和乌干达的疑诊患者,这2个地区可以提供用于确诊1例增加的TB病例所需的检查数量。结果:在摩尔多瓦有9%(1141/12525),在乌干达有20%(7280/36054)的疑诊病例通过至少1次阳性痰涂片确诊为TB病例。通过第3次检查得到的增加病例比例在摩尔多瓦是4%,在乌干达为3%。为了通过第3次痰涂片检查而确诊1例增加的TB病例,在摩尔多瓦需检查273张涂片(95%可信区间200—389)、乌干达需检查175张涂片(95%可信区间153—222),平均确诊时间分别为11d(8～16)和7d(6～9)。结论:在这2个国家,第3次痰涂片检查对诊断痰涂片阳性TB是无效的。
Location: Moldova and Uganda have 24 and 30 tuberculosis (TB) microscopy laboratories, respectively. OBJECTIVE: To evaluate the workload of the third sputum smear test for the diagnosis of one case of increased TB. METHODS: A retrospective, laboratory-based study was conducted to determine the prevalence of TB and the number of cases increased by the third sputum smear. The TB cases were from suspected patients in Moldova and Uganda, and the two areas were available for diagnosis 1 case of increased number of cases of TB examination. RESULTS: Suspected cases of 9% (1141/12525) in Moldova and 20% (7280/36054) in Uganda were diagnosed as TB cases with at least one positive sputum smear. The proportion of cases increased by the third examination was 4% in Moldova and 3% in Uganda. In order to confirm the diagnosis of an additional case of TB by the third sputum smear, 273 smears (95% confidence interval 200-389) were examined in Moldova and 175 smears (95% confidence interval 153-222). The mean definite diagnosis time was 11d (8 ~ 16) and 7d (6 ~ 9) respectively. CONCLUSIONS: In these two countries, the third sputum smear is ineffective in diagnosing sputum smear-positive TB.