Informing the TB suspect for sputum sample collection and communicating laboratory results in Nicaragua: a neglected process in tuberculosis case finding.

OBJECTIVE To assess the patient information process before sputum sample collection, the quality of sputum sample and transmission of acid-fast bacilli (AFB) examination results to TB suspects, in three local areas of Nicaragua. METHODS (a) directed interviews of consecutive series of TB suspects whose sputum had been examined for AFB; (b) directed interview of health personnel; and (c) assessment of the sputum sample quality. RESULTS A total of 115 TB suspects and 33 health personnel were interviewed and 625 sputum samples were assessed. Results show multiple weaknesses in the process of information to the patient during sputum collections, as well as in the communication of results. CONCLUSIONS This study unveiled an aspect usually overlooked of case finding, that is, the information process during sputum production, sputum sample quality, and the communication of results to the TB suspects. The results illustrate the need for routine assessment of the whole diagnostic process.