Audit of the practice of sputum smear examination for patients with suspected pulmonary tuberculosis in Fiji.

Background: In Fiji, patients with suspected pulmonary tuberculosis (PTB) currently submit three sputum specimens for smear microscopy for acid-fast bacilli, but there is little information about how well this practice is carried out.

Methods: A cross-sectional retrospective review was carried out in all four TB diagnostic laboratories in Fiji to determine among new patients presenting with suspected PTB in 2011: the quality of submitted sputum; the number of sputum samples submitted; the relationship between quality and number of submitted samples to smear-positivity; and positive yield from first, second and third samples.

Results: Of 1940 patients with suspected PTB, 3522 sputum samples were submitted: 997 (51.