Practical Approach to Lung Health - Experience from the Republic of Macedonia.

Background: Among the adults and children aged 5 yrs who attend PHC settings, 20-30% seeks to care for respiratory symptoms. Over 80-90% of the respiratory patients suffer from acute respiratory infections (ARI), followed by chronic obstructive pulmonary diseases (COPD), asthma, and less frequently with pneumonia and tuberculosis (TB). To improve the quality of care in patients who seek assistance for respiratory symptoms in PHC settings and the efficiency of respiratory service delivery within healthcare systems, WHO has designated several initiatives among which one is PAL (Practical Approach to Lung Health).

Comparison of Lumin LED fluorescent attachment, fluorescent microscopy and Ziehl-Neelsen for AFB diagnosis.

Design: Cross-sectional studies in Russia (n = 502) and Macedonia (n = 205), with fluorochrome-stained sputum examined by 1) the new Lumin light emitting diode (LED) fluorescent attachment on a light microscope, and 2) conventional fluorescent microscope (CFM) available in each laboratory, and compared to 3) Ziehl-Neelsen (ZN) restaining/reading of the same smears. Poor readings of ZN-restained smears in Russia stimulated a retrospective laboratory registry analysis for sensitivity and specificity of directly ZN-stained smears (n = 791) from a previous period.

Results: In Macedonia, the sensitivity of the Lumin and CFM were 87.