{'fraction_non_alphanumeric': 0.030482256596906277, 'fraction_numerical': 0.006824385805277525, 'mean_word_length': 5.525222551928783, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Implementation of Same-Day Sputum Smears Microscopy in Addis Ababa, Ethiopia: Programmatic Qualitative Study

Introduction: In countries that have ensured effective External Quality Assessment (EQA) sputum smear microscopy, World Health Organization (WHO) has recommended the implementation of same-day smear sputum microcopy. In Addis Ababa, Ethiopia, the status of the same-day sputum smear microcopy implementation was not yet assessed. Objective: To assess the status of same-day sputum smear microscopy implementation in Health Facilities (HFs) of Addis Ababa, Ethiopia from June to September 2018. Methods: In-depth interview of Health Care Providers (HCPs) at Outpatient Departments (OPDs), clinical laboratories and Directly Observed Treatment Short Course (DOTS) centres was conducted to assess the status of same-day sputum smear microscopy policy uptake, implementation and practices in selected HFs for the study. Check list based laboratory records review of 28 HFs were conducted to assess the status of same-day sputum smear microscopy implementation. Results: All public and only 1 (10%) of private HFs that were licensed to provide Tuberculosis (TB) diagnostic and DOTS services have implemented same-day sputum smear microscopy. In 10 (83.34%) public HFs that have implemented same-day sputum microcopy, smear results were available for presumptive and confirmed TB patients in batch in the afternoon. While confirmed TB patients were waiting for smear results until afternoon, it allows contact with non-presumptive patients that came to seek other health care services (might facilitates TB transmission) or some of the confirmed TB patients returned back to their home until smear results were available for them (might contributed to the diagnostic drop-out) and transmission of TB within the community. Conclusion: The implementation of same-day sputum smear microscopy in Addis Ababa, Ethiopia didn’t comply WHO policy recommendation. Awareness creation for HCPs on same-day sputum smear microscopy implementation and early anti-TB treatment initiation for sputum smear positives on same-day of their diagnosis reduces transmission of TB and defaulter from diagnostic paths.