Part II: Microscopy
specimen storage and transport

If the health facility does not perform its own microscopy, the collected sputum specimens must be brought to the laboratory. This transport should take place once or twice a week. Consequently, the specimens collected over a period of a few days must be kept at the health centre and transported together in one batch to the laboratory. A special box with the sputum containers should be kept refrigerated or in as cool a place as possible until it is dispatched.

Requirements and recommendations for the safe transport of pathological specimens are given in various national and international codes of practice and guidelines. In addition, the postal and transport authorities of most countries as well as the International Air Transport Association (IATA) have regulations about conveying such materials.

As a general rule, diagnostic specimens must be packaged to withstand leakage of contents, shocks, pressure changes and other conditions incident to ordinary handling practices. Pathological material intended for postal or air transport should be in approved, robust, leak-proof primary containers which are packed into secondary containers made of metal, wood or strong cardboard with enough absorbent material so that if they are damaged or leak the fluids will be absorbed. For sending material across international or state boundaries this container may have to be packed in the same way in an outer container and special administrative arrangements with the postal authorities and airlines may be necessary.

Sputum specimens comprise the majority of specimens submitted to tuberculosis microscopy laboratories and special transport boxes of metal or wood should be provided. They should be made to hold between 20 and 30 specimen containers packed vertically to avoid leaking. The lid should be securely fastened and the box should preferably contain a locking mechanism. During transport it must be kept as cool as possible and protected from sunlight.

Request forms should be located separately from specimen containers. With each transport box an accompanying list must be prepared which identifies the specimens and the patients from whom the specimens were collected. Before dispatch from the health centre the following must be verified:

• that the number of specimen containers in the box corresponds to that on the accompanying list
• that the identification number on each specimen container corresponds to the identification number on the accompanying list
• that the accompanying list contains the necessary data for each patient
• that the date of dispatch and the particulars of the health centre are on the accompanying list

A model laboratory request form is presented in Annex 3.