Awareness of EXTERNAL QUALITY ASSESSMENT network for AFB sputum smear microscopy and DST for M.tuberculosis among Post Graduate Medical Students

Laboratory Diagnosis of Acid-fast bacilli by Sputum Smear Microscopy is an important component of Revised National Tuberculosis control Program (RNTCP). An effective External Quality Assessment (EQA) network would install confidence in RNTCP diagnostic algorithm. RNTCP has implemented specific programs such as Public Private Mix (PPM) involving the participation of Private Medical practitioners, Medical colleges, Non-Governmental organizations, and corporate hospitals. To assess the awareness of EQA structure and functional implementation aspects and for Drug resistance surveillance, a written survey was conducted. Postgraduate medical students attending Indian Association of Medical Microbiologists (IAMM) IX annual meeting of Karnataka Chapter participated in this study. A methodology of pre-test, structured lecture and discussion, followed by a post-test that incorporated all the aspects of revised EQA guidelines for smear microscopy and finer aspects of drug sensitivity testing (DST) was adopted. The average performance of participants regarding questions on ‘Methodology for Sputum smear- ZN staining and result grading as per RNTCP’ and questions on ‘mycobacterial culture and Drug resistance surveillance’ were 44.5% and 30% for pre-test, that changed to 88.2% and 70.9%, respectively in the post-test assessment. The average performance for questions on ‘Structural organization of EQA network’ and questions on ‘Functional organization of EQA network’ between pre and post test was from 22.7% to 54.4%, and 36.6% to 69.9%, respectively. The methodology used, and the questionnaire developed for this purpose could be used as an instrument for large scale studies of this nature before RNTCP makes imperative policy decisions regarding EQA network in the private sector in India.