SHANDONG UNIVERSITY- CHINA

TB sputum collection/microscopy centres evaluation, with the NTP China

Setting up sputum collecting centres at the township hospital has become a national policy in China since Sept 2004. To increase case identification rate the Ministry of Health issued the policy to establish sputum collecting centres (SCC) at 1/3 of all township hospitals across China. The governments have allocated related resources to township hospitals to build SCCs, such as microscopes, training of sputum smears and disposal smear slides. However, many issues are unclear in the policy itself, such as where to set up an SCC, how to manage the SCC and what the impacts are for patients (do patients benefit from the SCCs or are they actually more prone to be explored by the township hospitals). This is a proposal for a follow-up to the study conducted in Shandong province. Based on the COMDIS microscopy centres evaluation in Shandong, the NCTP requested Nuffield's collaboration for a nation wide study to investigate these issues. This is the first well-designed study conducted nationally with aims to improve the SCC national policy in China. Current performance of SCCs and problems and lessons learned will be assessed. The study develops criteria of establishing SCCs and other operational issues to improve the SCC performance nationally.

The evaluation scheme has been designed and implemented in Shandong. The study includes SCC institutional survey, interview with TB suspect and health staff in the township hospitals and the county CDCs and evaluation of quality of sputum microscopy. The study is of national relevance for the National TB control. China is the world's highest TB burden country, with a quarter of the global population, so this work is of international importance.