Open Access Open Badges Research article

The role of AFB microscopy training in improving the performance of laboratory professionals: analysis of pre and post training evaluation scores

Pawlos Reji1, Getachew Aga2 and Gemeda Abebe3*

Author Affiliations

1 TB CARE I/ Management Sciences for Health, Addis Ababa, Ethiopia

2 Oromia Health Bureau, Addis Ababa, Ethiopia

3 Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia

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BMC Health Services Research 2013, 13:392  doi:10.1186/1472-6963-13-392

Published: 7 October 2013



Tuberculosis (TB) remains major cause of morbidity and mortality due to any one of infectious agent worldwide. In low income countries, Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment. In order to have efficient AFB microscopy centers, it is imperative to have continuous refresher training for laboratory professionals and strong External Quality Assessment (EQA) system). However, very little data exists as to the effect of in-service training on performance of laboratory personnel in Ethiopia.

The objective of this study was to investigate the role of AFB microscopy refresher training on the performance of laboratory professionals.


A cross-sectional retrospective study was conducted to appraise theoretical and practical performance of laboratory professionals before and after AFB microscopy training. Theoretical assessment was based on standard questions while practical assessment was based on smear reading of 10 standard slides. Data on eight rounds of a five days training at Adama regional laboratory on AFB microscopy in 2009 was obtained and analyzed using SPSS 16.0 statistical software.


The pre-training mean score of the theoretical knowledge and practical skills were 61.8% and 75.7%, respectively. The post training mean scores were 84.2% and 89.2% for theoretical knowledge and practical skills, respectively. The increase in mean score of both theoretical and practical assessment was statistically significant (p < 0.0001). Post training mean score of theoretical knowledge was higher among diploma holders trainees than the BSc degree counter parts (p = 0.001). The mean scores on practice before and after training was dependent on participation in previous AFB microscopy trainings (p < 0.0001). Proportions of trainees with both major and minor errors were found to decrease after they were trained. Trainees who have had previous training were found to commit less errors than those who were not participated in previous training (p < 0.0001).


Training has improved theoretical and practical performance of laboratory professionals. Pre-placement and continuous training irrespective of lab professionals qualification and service year and sustainable EQA are highly recommended to ensure quality of AFB microscopy service.

Tuberculosis; AFB; Refresher training; Scores