Same-day sputum smear microscopy for the diagnosis of pulmonary tuberculosis: direct vs. concentrated smear
METHODS: Three sputum specimens (spot, second spot and morning) were collected from study participants. Three smears were prepared from the direct sample and three using the N-acetyl-l-cysteine-sodium hydroxide concentration method. The smears were stained using Ziehl-Neelsen (ZN) staining, modified ZN (MZN) staining and fluorescent staining (FS). Smear results were pooled and compared in two categories: standard spot and morning, and same-day smears. The χ2 test was used to evaluate the statistical difference in smear-positive cases.
RESULTS: Among 3186 participants included in the study, smear positivity was respectively 9.6%, 9.8% and 10.8% for ZN, MZN and FS smears using spot and morning smears. Using same-day smears, smear positivity was respectively 9.5%, 9.8% and 10.6% for ZN, MZN and FS smears. Smear positivity increased to 16% with the concentration method.
CONCLUSION: Nil dropouts and patient convenience are the added advantages of using same-day smears, and the concentration method improved smear positivity. Given these advantages, using same-day smears with the concentration method should be considered by the World Health Organization and India's Revised National Tuberculosis Control Programme.
Document Type: Research Article
Affiliations: 1: *Department of Microbiology, GSL Medical College, Rajahmundry 2: †Centre for Laboratory Animal Technology and Research, Sathyabama University, Chennai 3: †Department of Pathology, GSL Medical College, Rajahmundry, India
Publication date: February 1, 2016
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