Performance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.

<h4>Background</h4>Sputum microscopy is the only tuberculosis (TB) diagnostic available at peripheral levels of care in resource limited countries. Its sensitivity is low, particularly in high HIV prevalence settings. Fluorescence microscopy (FM) can improve performance of microscopy and...

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Autores principales:	Maryline Bonnet, Laramie Gagnidze, Willie Githui, Philippe Jean Guérin, Laurence Bonte, Francis Varaine, Andrew Ramsay
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/339f91a4718744abad2e07b2ecc5902c
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spelling	oai:doaj.org-article:339f91a4718744abad2e07b2ecc5902c2021-11-18T06:58:33ZPerformance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.1932-620310.1371/journal.pone.0017214https://doaj.org/article/339f91a4718744abad2e07b2ecc5902c2011-02-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21364757/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Sputum microscopy is the only tuberculosis (TB) diagnostic available at peripheral levels of care in resource limited countries. Its sensitivity is low, particularly in high HIV prevalence settings. Fluorescence microscopy (FM) can improve performance of microscopy and with the new light emitting diode (LED) technologies could be appropriate for peripheral settings. The study aimed to compare the performance of LED-FM versus Ziehl-Neelsen (ZN) microscopy and to assess feasibility of LED-FM at a low level of care in a high HIV prevalence country.<h4>Methods</h4>A prospective study was conducted in an urban health clinic in Nairobi, Kenya. Three sputum specimens were collected over 2 days from suspected TB patients. Each sample was processed with Auramine O and ZN methods and a 4(th) specimen was collected for TB culture reference standard. Auramine smears were read using the same microscope, equipped with the FluoLED™ fluorescence illuminator. Inter-reader agreement, reading time and technicians' acceptability assessed feasibility.<h4>Results</h4>497 patients were included and 1394 specimens were collected. The detection yields of LED-FM and ZN microscopy were 20.3% and 20.6% (p = 0.64), respectively. Sensitivity was 73.2% for LED-FM and 72% for ZN microscopy, p = 0.32. It was 96.7% and 95.9% for specificity, p = 0.53. Inter-reader agreement was high (kappa = 0.9). Mean reading time was three times faster than ZN microscopy with very good acceptance by technicians.<h4>Conclusions</h4>Although it did not increase sensitivity, the faster reading time combined with very good acceptance and ease of use supports the introduction of LED-FM at the peripheral laboratory level of high TB and HIV burden countries.Maryline BonnetLaramie GagnidzeWillie GithuiPhilippe Jean GuérinLaurence BonteFrancis VaraineAndrew RamsayPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 2, p e17214 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maryline Bonnet Laramie Gagnidze Willie Githui Philippe Jean Guérin Laurence Bonte Francis Varaine Andrew Ramsay Performance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.
description	<h4>Background</h4>Sputum microscopy is the only tuberculosis (TB) diagnostic available at peripheral levels of care in resource limited countries. Its sensitivity is low, particularly in high HIV prevalence settings. Fluorescence microscopy (FM) can improve performance of microscopy and with the new light emitting diode (LED) technologies could be appropriate for peripheral settings. The study aimed to compare the performance of LED-FM versus Ziehl-Neelsen (ZN) microscopy and to assess feasibility of LED-FM at a low level of care in a high HIV prevalence country.<h4>Methods</h4>A prospective study was conducted in an urban health clinic in Nairobi, Kenya. Three sputum specimens were collected over 2 days from suspected TB patients. Each sample was processed with Auramine O and ZN methods and a 4(th) specimen was collected for TB culture reference standard. Auramine smears were read using the same microscope, equipped with the FluoLED™ fluorescence illuminator. Inter-reader agreement, reading time and technicians' acceptability assessed feasibility.<h4>Results</h4>497 patients were included and 1394 specimens were collected. The detection yields of LED-FM and ZN microscopy were 20.3% and 20.6% (p = 0.64), respectively. Sensitivity was 73.2% for LED-FM and 72% for ZN microscopy, p = 0.32. It was 96.7% and 95.9% for specificity, p = 0.53. Inter-reader agreement was high (kappa = 0.9). Mean reading time was three times faster than ZN microscopy with very good acceptance by technicians.<h4>Conclusions</h4>Although it did not increase sensitivity, the faster reading time combined with very good acceptance and ease of use supports the introduction of LED-FM at the peripheral laboratory level of high TB and HIV burden countries.
format	article
author	Maryline Bonnet Laramie Gagnidze Willie Githui Philippe Jean Guérin Laurence Bonte Francis Varaine Andrew Ramsay
author_facet	Maryline Bonnet Laramie Gagnidze Willie Githui Philippe Jean Guérin Laurence Bonte Francis Varaine Andrew Ramsay
author_sort	Maryline Bonnet
title	Performance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.
title_short	Performance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.
title_full	Performance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.
title_fullStr	Performance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.
title_full_unstemmed	Performance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.
title_sort	performance of led-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in nairobi.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/339f91a4718744abad2e07b2ecc5902c
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Performance of LED-based fluorescence microscopy to diagnose tuberculosis in a peripheral health centre in Nairobi.

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