Impact of Sputum Sampling Instructional Video on Ziehl-Neelsen Positivity in Tuberculosis Diagnostic Centers at BOMA: Multicenter Randomized Controlled Trial

Background and Purpose: Tuberculosis is a global scourge. In DRC, Ziehl-Neelsen (ZN) is the most widely used reference test for the detection of Mycobacterium tuberculosis. Its performance can be improved by certain strategies before sputum collection, particularly the instructional video. The purpose of this study is to evaluate the effectiveness of the instructional video showing and explaining appropriate sputum collection techniques for the diagnosis of tuberculosis. Methods: Multicenter, single-blind, randomized controlled trial conducted in Boma. Two hundred suspected TB assigned at random, either to the intervention group (n = 100) before sputum collection, or to the control group (n = 100). Sputum quality was assessed by appearance and volume before ZN staining by laboratory technicians blind to study groups. Results: The mean age was 38.1 ± 16.0 years. In the two samples (Contact and morning), the positive smear rate was very significant (p