Same-day light-emitting diode fluorescence microscopy for the diagnosis of tuberculosis in Chhattisgarh, India
Three medical college hospitals using light-emitting diode fluorescence microscopy (LED-FM) for diagnosing tuberculosis (TB) in Chhattisgarh, India.
To assess and compare the proportion of sputum smear-positive TB patients diagnosed through same-day microscopy (spot-spot) strategy or with the conventional (spot-morning) strategy.
During November 2012 - March 2013, all consecutively enrolled presumptive TB patients (aged 18 years) were requested to provide three specimens: two spot specimens collected 1 h apart on the first day and one early morning specimen the next day; these were stained using auramine-O and examined using LED-FM.
Of 1716 (93% of total 1845) presumptive TB patients who provided all three specimens, 218 (13%) were smear-positive: 200 (11.7%) by same-day microscopy and 217 (12.7%) by the conventional method (McNemar's χ2 13.5, df 1, P = 0.0002). Eighteen (8.3%) cases were missed by the same-day method.
Although LED-FM is more sensitive to paucibacillary samples, 8% of smear-positive cases were missed using the same-day method. These findings indicate the need to revisit the global applicability of the current World Health Organization recommendation of switching to same-day diagnosis from the conventional policy.
Document Type: Research Article
Affiliations: 1: World Health Organization Country Office for India, New Delhi, India 2: International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India 3: State Tuberculosis Office, Directorate of Health Services, Raipur, Chhattisgarh, India 4: Intermediate Reference Laboratory, Raipur, Chhattisgarh, India
Publication date: June 1, 2014
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.
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