Authors: Van Deun, A.¹; Hamid Salim, A.²; Aung, K.J.M.²; Hossain, M.d.A.²; Chambugonj, N.²; Hye, M.d.A.²; Kawria, A.²; Declercq, E.³

Source: The International Journal of Tuberculosis and Lung Disease, Volume 9, Number 10, October 2005 , pp. 1127-1133(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: A field project in Bangladesh.

OBJECTIVE: To compare the effectiveness of commonly used carbolfuchsin staining variations.

DESIGN: Routine hot Ziehl-Neelsen (ZN) 1% basic fuchsin staining for 15 min in 75 field clinics. Blind reading of duplicate smears stained by ZN 1% vs. 0.3% basic fuchsin applied for 5 min, or by ZN 1% 5 min vs. Kinyoun cold staining. Rechecking of discordant series.

RESULTS: For comparable numbers of false positives, sensitivity was significantly lower with Kinyoun than with ZN 1% 5 min (85.6% vs. 93.0%, P < 0.001). Sensitivity with ZN 1% 5 min was not significantly higher than with 0.3% 5 min staining (89.9% vs. 86.5%). Routine examination using 1% 15 min ZN identified more positives than any of the study techniques.

CONCLUSIONS: Kinyoun cold staining sensitivity was unsatisfactory in field clinics. The sensitivity of the WHO/IUATLD recommended 0.3% fuchsin for 5 min was not significantly different from the original 1% ZN for 5 min, but 1% 15 min hot staining might be superior. A reduced fuchsin concentration together with a short staining time may leave too narrow a margin for error. TB programmes using hot ZN with a concentrated stain or longer staining time should not be urged to change.

Keywords: Ziehl-Neelsen; carbolfuchsin; microscopy; staining

Document Type: Regular paper

Affiliations: 1: Mycobacteriology Unit, Institute of Tropical Medicine, Antwerpen, Belgium; and International Union against Tuberculosis and Lung Disease, Paris, France 2: Damien Foundation Bangladesh, Dhaka, Bangladesh 3: Damien Foundation Belgium, Brussels, Belgium

Publication date: 2005-10-01

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