Global Journal of Medical Research, K: Interdisciplinary, Volume 22 Issue 4

Table: data collection of twelve weeks on implementation of new secondary package Two districts (Morrumbala and Namacurra) has 0 rejections. The Health facility with more rejected sample were Impaca (6) and Naburi (5) both in Pebane district, all associated with the improvised boxes. No spillover or rejected sample notified for all districts, using the new secondary package. Namacurra was the district that had a lot of irregularity in the report, having reported data only in weeks 1, 3, 5, 9 and 12. A total of 108 originated were referenced, without any rejection. Comparing the improvised boxes used by the activists and motorbike riders, we can see that they are not appropriate leak-proof seal. In case of spill is common to lose the patient opportunity to test and minimize the chance of spreading TB. Although the first approach in packaging sample must be follow the international standards, related to triple packaging as recommended, the required material is scares in the country. This is why people try to adopt easy solution to deliver the samples for testing. IV. D iscussion The interpretation of the microbiological results depends, to a great extent, on the quality of the samples received for study. Therefore, an appropriate management of the samples is necessary to achieve an optimal diagnosis in Microbiology [7]. The analyzable substances are all the biological samples available, from sterile fluids, samples from different organs or systems, such as faeces, urine, sputum, Broncho alveolar lavage, aspirates, biopsies and exudates from different locations or superficial or deep lesions, and hospital devices, such as catheters and prostheses [8]. There is a great variety of containers in which microbiological samples can be collected, with a common characteristic to all of them being that they are sterile and with a leak-proof seal [7]. The issue in the process of sample transportation, a part of the type of container, avoid spillage must be considered. As in other low-income countries, missed cases of TB have been attributed in part to difficulties transporting and handling TB specimens and Mozambique is not an exception [9]. Road infrastructure is poor and at times impassable and also contribute for spill increasing and loss of specimen [10]. The handling of the samples should only be carried out by trained and qualified personnel, who should also be in charge of their safekeeping and organization of the transportation [11]. Since samples are transported by couriers who do not take care of the samples and sometimes do not show evidence of training in biological sample management, this may be associated with the high number of spills, given the road situation also. To transport all infectious substances, the basic triple packaging system must be used. This transport system comprises three layers: Primary container, which is the primary leak-proof and watertight container that contains the sample. This container should be wrapped in absorbent material with the capacity to absorb all the fluid in case of breakage or leakage; Secondary container, resistant, watertight, leak-proof container that encloses and protects the primary container. Several wrapped primary containers can be placed in a secondary container, but sufficient absorbent material must be used to absorb all the fluid in case of breakage or leakage and Outer container, where the secondary 131 127 220 182 214 201 202 203 325 344 274 266 4% 3% 2% 4% 2% 3% 2% 3% 0% 0% 0% 0% 0%1%1%2%2%3%3%4%4%5%5% 0 50 100 150 200 250 300 350 400 W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12 Weekly report about the implementation of new secondary package N° HFs N° Activists N° Motobikers N° of referral samples N° of rejected samples % Rejections 43 Year 2022 Global Journal of Medical Research Volume XXII Issue IV Version I ( D ) K © 2022 Global Journals Improvement on Packaging and Referencing Tuberculosis Samples- Experience in Zambezia, Mozambique