Effect of on-site support on laboratory practice for human immunodeficiency virus, tuberculosis, and malaria testing

Sarah M. Burnett, Martin K. Mbonye, Robert Martin, Allan Ronald, Stella Zawedde-Muyanja, Kelly S. Willis, Robert Colebunders, Yukari C. Manabe, Marcia R. Weaver

Research output: Contribution to journalA1: Web of Science-article

Abstract

Objectives: To evaluate the effect of on-site support in improving human immunodeficiency virus (HIV) rapid testing, tuberculosis (TB) sputum microscopy, and malaria microscopy among laboratory staff in a low-resource setting.

Methods: This cluster randomized trial was conducted at 36 health facilities in Uganda. From April to December 2010, laboratory staff at 18 facilities participated in monthly on-site visits, and 18 served as control facilities. After intervention, 128 laboratory staff were observed performing 587 laboratory tests across three diseases: HIV rapid testing, TB sputum microscopy, and malaria microscopy. Outcomes were the proportion of laboratory procedures correctly completed for the three laboratory tests.

Results: Laboratory staff in the intervention arm performed significantly better than the control arm in correctly completing laboratory procedures for all three laboratory tests, with an adjusted relative risk (95% confidence interval) of 1.18 (1.10-1.26) for HIV rapid testing, 1.29 (1.21-1.40) for TB sputum microscopy, and 1.19 (1.11-1.27) for malaria microscopy.

Conclusions: On-site support significantly improved laboratory practices in conducting HIV rapid testing, TB sputum microscopy, and malaria microscopy. It could be an effective method for improving laboratory practice, without taking limited laboratory staff away from health facilities for training.

Original languageEnglish
JournalAmerican Journal of Clinical Pathology
Volume146
Issue number4
Pages (from-to)469-477
Number of pages9
ISSN0002-9173
DOIs
Publication statusPublished - 2016

Keywords

  • TB sputum microscopy
  • HIV rapid testing
  • Malaria microscopy
  • Educational outreach
  • Supportive supervision
  • Uganda
  • Laboratory practice
  • Continuous quality improvement
  • QUALITY IMPROVEMENT INTERVENTION
  • RANDOMIZED CONTROLLED-TRIAL
  • PRIMARY-CARE
  • HEALTH-CARE
  • CASE-MANAGEMENT
  • MICROSCOPY
  • UGANDA
  • IMPACT
  • PROFESSIONALS
  • PERFORMANCE

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