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Open Access Is bleach-sedimented smear microscopy an alternative to direct microscopy under programme conditions in India? [Short communication]

This cross-sectional multi-centric study compared the yield of and potential benefit for detecting smear-positive pulmonary tuberculosis (PTB) by bleach sedimentation (2% sodium-hypochlorite) versus direct microscopy under programme conditions in India. Among 3168 PTB suspects, 684 (21.6%) were detected by bleach sedimentation vs. 625 (19.7%) by direct microscopy, with a proportional overall agreement of 96% ( 0.88). While 594 patients were smear-positive with both methods, 31 patients detected by direct microscopy were missed and an additional 90 patients were detected by bleach sedimentation. Overall, bleach sedimentation increased the yield of smear-positive TB detection; however; it also increased the time to results.

Keywords: TB diagnosis; bleach sedimentation; bleach smears; conventional microscopy; direct smears

Document Type: Research Article

Affiliations: 1: State Tuberculosis Training and Demonstration Centre, Hyderabad, Andra Pradesh, India 2: World Health Organization Revised National Tuberculosis Control Programme Technical Assistance Project, New Delhi, India 3: Regional Office for South-East Asia, International Union Against Tuberculosis and Lung Disease, New Delhi, India 4: Revised National Tuberculosis Control Programme State Tuberculosis Office, Bhopal, Madhya Pradesh, India 5: Revised National Tuberculosis Control Programme State Tuberculosis Office, Hyderabad, Andra Pradesh, India 6: Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India 7: Regional Medical Research Center for Tribals, Jabalpur, Madhya Pradesh, India 8: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Publication date: March 21, 2013

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