Safety in laboratories carrying out sputum smear microscopy: a dilemma for resource-poor countries

Laboratory conditions and procedures for sputum smear microscopy (acid-fast bacilli) were assessed in 38 hospitals throughout Malawi. Of these, 17 (45%) had an area of less than 25 m2, eight (21%) had a separate room for tuberculosis work, and five (13%) had a safety cabinet. All laboratory personnel wore gloves, but in several hospitals there was no white coat, face mask, protective apron or soap for washing hands. Different disinfectants were used to clean work surfaces, only one laboratory decontaminated sputum specimens before disposal, and the laboratory cleaner was usually responsible for waste disposal. Laboratory conditions and safety procedures in Malawi are poor, indicating a need for education, training and supervision of staff.