New policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.

<h4>Background</h4>To quantify the likely impact of recent WHO policy recommendations regarding smear microscopy and the introduction of appropriate low-cost fluorescence microscopy on a) case detection and b) laboratory workload.<h4>Methodology/principal findings</h4>An audi...

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Autores principales:	Andrew Ramsay, Luis E Cuevas, Catherine J F Mundy, Carl-Michael Nathanson, Petros Chirambo, Russell Dacombe, S Bertel Squire, Felix M L Salaniponi, Sera Munthali
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a3b319369b3c4ff4a3beca32ed9cd2d1
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spelling	oai:doaj.org-article:a3b319369b3c4ff4a3beca32ed9cd2d12021-11-25T06:28:14ZNew policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.1932-620310.1371/journal.pone.0007760https://doaj.org/article/a3b319369b3c4ff4a3beca32ed9cd2d12009-11-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19901989/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>To quantify the likely impact of recent WHO policy recommendations regarding smear microscopy and the introduction of appropriate low-cost fluorescence microscopy on a) case detection and b) laboratory workload.<h4>Methodology/principal findings</h4>An audit of the laboratory register in an urban hospital, Lilongwe, Malawi, and the application of a simple modelling framework. The adoption of the new definition of a smear-positive case could directly increase case detection by up to 28%. Examining Ziehl-Neelsen (ZN) sputum smears for up to 10 minutes before declaring them negative has previously been shown to increase case detection (over and above that gained by the adoption of the new case definition) by 70% compared with examination times in routine practice. Three times the number of staff would be required to adequately examine the current workload of smears using ZN microscopy. Through implementing new policy recommendations and LED-based fluorescence microscopy the current laboratory staff complement could investigate the same number of patients, examining auramine-stained smears to an extent that is equivalent to a 10 minutes ZN smear examination.<h4>Conclusions/significance</h4>Combined implementation of the new WHO recommendations on smear microscopy and LED-based fluorescence microscopy could result in substantial increases in smear positive case-detection using existing human resources and minimal additional equipment.Andrew RamsayLuis E CuevasCatherine J F MundyCarl-Michael NathansonPetros ChiramboRussell DacombeS Bertel SquireFelix M L SalaniponiSera MunthaliPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 4, Iss 11, p e7760 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Andrew Ramsay Luis E Cuevas Catherine J F Mundy Carl-Michael Nathanson Petros Chirambo Russell Dacombe S Bertel Squire Felix M L Salaniponi Sera Munthali New policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.
description	<h4>Background</h4>To quantify the likely impact of recent WHO policy recommendations regarding smear microscopy and the introduction of appropriate low-cost fluorescence microscopy on a) case detection and b) laboratory workload.<h4>Methodology/principal findings</h4>An audit of the laboratory register in an urban hospital, Lilongwe, Malawi, and the application of a simple modelling framework. The adoption of the new definition of a smear-positive case could directly increase case detection by up to 28%. Examining Ziehl-Neelsen (ZN) sputum smears for up to 10 minutes before declaring them negative has previously been shown to increase case detection (over and above that gained by the adoption of the new case definition) by 70% compared with examination times in routine practice. Three times the number of staff would be required to adequately examine the current workload of smears using ZN microscopy. Through implementing new policy recommendations and LED-based fluorescence microscopy the current laboratory staff complement could investigate the same number of patients, examining auramine-stained smears to an extent that is equivalent to a 10 minutes ZN smear examination.<h4>Conclusions/significance</h4>Combined implementation of the new WHO recommendations on smear microscopy and LED-based fluorescence microscopy could result in substantial increases in smear positive case-detection using existing human resources and minimal additional equipment.
format	article
author	Andrew Ramsay Luis E Cuevas Catherine J F Mundy Carl-Michael Nathanson Petros Chirambo Russell Dacombe S Bertel Squire Felix M L Salaniponi Sera Munthali
author_facet	Andrew Ramsay Luis E Cuevas Catherine J F Mundy Carl-Michael Nathanson Petros Chirambo Russell Dacombe S Bertel Squire Felix M L Salaniponi Sera Munthali
author_sort	Andrew Ramsay
title	New policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.
title_short	New policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.
title_full	New policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.
title_fullStr	New policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.
title_full_unstemmed	New policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.
title_sort	new policies, new technologies: modelling the potential for improved smear microscopy services in malawi.
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/a3b319369b3c4ff4a3beca32ed9cd2d1
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New policies, new technologies: modelling the potential for improved smear microscopy services in Malawi.

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