{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:37:03Z","timestamp":1788352623364,"version":"build-2803163510"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T00:00:00Z","timestamp":1241740800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Sputum smear microscopy is the standard diagnostic method for detection of smear positive pulmonary tuberculosis (TB). Insufficient quality of sputum might result in missing cases. In this study we aimed at assessing the quality of sputum in a district in Central Java and determining patient and health worker factors associated with submission of three good quality sputum samples.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In 16 health centers information was collected on the quality of sputum submitted by TB suspects, i.e. volume, color, and viscosity. TB suspects were interviewed to assess their knowledge of TB, motivation to provide sputum and whether they were informed why and how to produce a sputum sample. Health workers were interviewed to assess what information they provided to TB suspects about the reason for sputum examination, methods to produce sputum and characteristics of a good quality sputum sample. All health worker and patient factors were evaluated for association with sputum quality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 387 TB suspects, 294 (76.0%) could be traced and interviewed, and of 272 (70.3%) information about sputum quality was available. Of those 203 (74.6%) submitted three samples, 90 (33.1%) provided at least one good sample, and 37 (13.6%) provided three good quality sputum samples. Of the 272 TB suspects, 168 (61.8%) mentioned that information on the reason for sputum examination was provided, 66 (24.3%) remembered that they were informed about how to produce sputum and 40 (14.7%) recalled being informed about the characteristics of good quality sputum. Paramedics reported to provide often\/always information on the importance of sputum examination, and when to produce sputum. Information on how to produce sputum and characteristics of a good sputum sample was less often provided. None of the studied patient characteristics or health worker factors was associated with providing good quality sputum.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>A considerable number of TB suspects did not provide three sputum samples and a large number of sputum samples were of insufficient quality. Training of health workers in providing health education to the TB suspect about the reason for sputum examination and how to produce a good quality sputum sample should be a priority of the TB program.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2466-9-16","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T18:57:19Z","timestamp":1241809039000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Insufficient quality of sputum submitted for tuberculosis diagnosis and associated factors, in Klaten district, Indonesia"],"prefix":"10.1186","volume":"9","author":[{"given":"Mateus","family":"Sakundarno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurjazuli","family":"Nurjazuli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sutopo Patria","family":"Jati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Retna","family":"Sariningdyah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumarsono","family":"Purwadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bachti","family":"Alisjahbana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke J","family":"van der Werf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2009,5,8]]},"reference":[{"key":"134_CR1","volume-title":"Global Tuberculosis Control: Surveillance, Planning, Financing. WHO report 2007","author":"WHO","year":"2007","unstructured":"WHO: Global Tuberculosis Control: Surveillance, Planning, Financing. WHO report 2007. 2007, Geneva: World Health Organization"},{"issue":"4","key":"134_CR2","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1016\/S0035-9203(97)90262-5","volume":"91","author":"AD Harries","year":"1997","unstructured":"Harries AD, Kamenya A, Subramanyam VR, Maher D, Squire SB, Wirima JJ, Nyangulu DS, Nunn P: Screening pulmonary tuberculosis suspects in Malawi: testing different strategies. Trans R Soc Trop Med Hyg. 1997, 91 (4): 416-419. 10.1016\/S0035-9203(97)90262-5.","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"11","key":"134_CR3","first-page":"994","volume":"5","author":"AC Crampin","year":"2001","unstructured":"Crampin AC, Floyd S, Mwaungulu F, Black G, Ndhlovu R, Mwaiyeghele E, Glynn JR, Warndorff DK, Fine PE: Comparison of two versus three smears in identifying culture-positive tuberculosis patients in a rural African setting with high HIV prevalence. Int J Tuberc Lung Dis. 2001, 5 (11): 994-999.","journal-title":"Int J Tuberc Lung Dis"},{"key":"134_CR4","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1164\/ajrccm.161.5.9908063","volume":"161","author":"JRBM Warren","year":"2000","unstructured":"Warren JRBM, De Almeida KN, Trakas K, Peterson LR: A minimum 5.0 ml of sputum improves the sensitivity of acid-fast smear for Mycobacterium tuberculosis. Am J Respir Crit Care Med. 2000, 161: 1559-1562.","journal-title":"Am J Respir Crit Care Med"},{"key":"134_CR5","unstructured":"Pedoman Nasional Penanggulangan Tuberkulosis. 2003, Departemen Kesehatan Republik Indonesia"},{"issue":"7","key":"134_CR6","first-page":"814","volume":"9","author":"B Alisjahbana","year":"2005","unstructured":"Alisjahbana B, vanCrevel R, Danusantoso H, Gartinah T, Soemantri ES, Nelwan RHH, Meer JWMvd: Better patient instruction for sputum sampling can improve microscopic tuberculosis diagnosis. Int J Tuberc Lung Dis. 2005, 9 (7): 814-817.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"2","key":"134_CR7","first-page":"33","volume":"79","author":"T Hirooka","year":"2004","unstructured":"Hirooka T, Higuchi T, Tanaka N, Ogura T: The value of proper sputum collection instruction in detection of acid-fast bacillus. Kekkaku. 2004, 79 (2): 33-37.","journal-title":"Kekkaku"},{"issue":"369","key":"134_CR8","doi-asserted-by":"publisher","first-page":"1955","DOI":"10.1016\/S0140-6736(07)60916-7","volume":"9","author":"MS Khan","year":"2007","unstructured":"Khan MS, Dar O, Sismanidis C, Shah K, Godfrey-Faussett P: Improvement of tuberculosis case detection and reduction of discrepancies between men and women by simple sputum-submission instruction: a pragmatic randomised controlled trial. Lancet. 2007, 9 (369): 1955-1960. 10.1016\/S0140-6736(07)60916-7.","journal-title":"Lancet"},{"key":"134_CR9","unstructured":"Central Java tuberculosis control program feed back report 2003. 2004, Central Java Provincial Health Office"},{"key":"134_CR10","volume-title":"Laboratory Services in Tuberculosis Control Part II: Microscopy","author":"I Narvaiz_De_Kantor","year":"1998","unstructured":"Narvaiz_De_Kantor I, Kim SJ, Frieden T, Laszlo A, Luelmo F, Norval P-Y, Rieder H, Valenzuela P, Weyer K: Laboratory Services in Tuberculosis Control Part II: Microscopy. 1998, Geneva: World Health Organization"},{"key":"134_CR11","unstructured":"Pedoman Nasional Penanggulangan Tuberkulosis. 2007, Departemen Kesehatan Republik Indonesia, 2"},{"key":"134_CR12","volume-title":"Situasi HIV-AIDS di Jawa Tengah","author":"L Herawati","year":"2005","unstructured":"Herawati L: Situasi HIV-AIDS di Jawa Tengah. 2005, Dinas Kesehatan Propinsi Jawa Tengah"},{"issue":"4","key":"134_CR13","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1590\/S0036-36342005000400008","volume":"47","author":"J Macq","year":"2005","unstructured":"Macq J, Solis A, Velazquez H, Dujardin B: Informing the TB suspect for sputum sample collection and communicating laboratory results in Nicaragua: a Neglected process in tuberculosis case finding. Salud Publica Mex. 2005, 47 (4): 303-307.","journal-title":"Salud Publica Mex"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2466-9-16.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2466-9-16\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2466-9-16","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2466-9-16.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T08:59:56Z","timestamp":1630486796000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/1471-2466-9-16"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5,8]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2009,12]]}},"alternative-id":["134"],"URL":"https:\/\/doi.org\/10.1186\/1471-2466-9-16","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,5,8]]},"assertion":[{"value":"5 August 2008","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2009","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2009","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"16"}}