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Free Content Comparison of Lumin™ LED fluorescent attachment, fluorescent microscopy and Ziehl-Neelsen for AFB diagnosis

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DESIGN: Cross-sectional studies in Russia (n = 502) and Macedonia (n = 205), with fluorochrome-stained sputum examined by 1) the new Lumin™ light emitting diode (LED) fluorescent attachment on a light microscope, and 2) conventional fluorescent microscope (CFM) available in each laboratory, and compared to 3) Ziehl-Neelsen (ZN) restaining/reading of the same smears. Poor readings of ZN-restained smears in Russia stimulated a retrospective laboratory registry analysis for sensitivity and specificity of directly ZN-stained smears (n = 791) from a previous period.

RESULTS: In Macedonia, the sensitivity of the Lumin and CFM were 87.8%, and that of restained ZN smears with conventional light microscope was 78.0%. In Russia, sensitivity was as follows: Lumin 72.8%, CFM 52.5%; re-stained ZN smears 28.5% and directly ZN stained smears 55.6%.

CONCLUSION: Fluorescence microscopy is more sensitive than conventional microscopy. The Lumin attachment to conventional light microscopes provided results equal to or better than the CFMs. Smear restaining for ZN showed a 12% advantage for Lumin and CFM in Macedonia, in line with other meta-analyses. Restaining for ZN gave poor results in Russia for unknown reasons. Retrospective analysis of directly ZN-stained smears showed 55.6% sensitivity compared to the Lumin (72.8%), which is also in line with the superiority of fluorescent microscopy reported in literature.

Keywords: LED; Lumin; Ziehl-Neelsen; diagnosis; fluorescence microscopy; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Independent consultant, clinical tuberculosis and program management, Cliffside Park, New Jersey, USA 2: Independent consultant, tuberculosis program design and evaluation, Verona, Virginia, USA 3: The Republic Clinical Tuberculosis Dispensary, Kazan State Medical Academy, Kazan, Russia 4: Institute of Lung Diseases and Tuberculosis, Skopje, Republic of Macedonia 5: Department of Statistics, Brigham Young University, Provo, Utah, USA

Publication date: July 1, 2009

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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