Evaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.

<h4>Background</h4>Sputum microscopy is the only diagnostic for tuberculosis (TB) available at peripheral levels of health service in resource-poor countries. Its sensitivity is reduced in high HIV-prevalence settings. Sodium hypochlorite (NaOCl) specimen sedimentation prior microscopy a...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Maryline Bonnet, Laramie Gagnidze, Philippe J Guerin, Laurence Bonte, Andrew Ramsay, Willie Githui, Francis Varaine
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/73673771b07547ee996781920b41845e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:73673771b07547ee996781920b41845e
record_format	dspace
spelling	oai:doaj.org-article:73673771b07547ee996781920b41845e2021-11-18T06:52:49ZEvaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.1932-620310.1371/journal.pone.0020175https://doaj.org/article/73673771b07547ee996781920b41845e2011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21655284/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Sputum microscopy is the only diagnostic for tuberculosis (TB) available at peripheral levels of health service in resource-poor countries. Its sensitivity is reduced in high HIV-prevalence settings. Sodium hypochlorite (NaOCl) specimen sedimentation prior microscopy and light-emitting diode (LED)-fluorescence microscopy (FM) can individually improve performance of microscopy. This study aimed to evaluate the performance of combined LED-FM and NaOCl sputum sedimentation for TB detection at peripheral level of health services.<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 consecutive TB suspects. Smears were prepared and stained with auramine O and Ziehl-Neelsen (ZN) methods. Bleach (3.5%) was added to the remaining specimen before overnight sedimentation at room temperature. Auramine O staining was performed on smears of sediment. A 4(th) specimen was collected for TB culture. Auramine smears were read under the same microscope as used for ZN smears, but equipped with the LED FluoLED™ fluorescence illuminator.<h4>Results</h4>497 patients were included, and 1394 specimens collected. The yield of positive specimen was significantly increased after NaOCl sedimentation (24.9%) compared to direct LED-FM (20.6%) and direct ZN (20.3%). In detecting smear-positive patients, sensitivity was 78.5% for LED-FM after NaOCl sedimentation compared to 73.2% and 72.0% for direct LED-FM (P = 0.06) and direct ZN (P = 0.06), respectively. Specificity was 87.8% for LED-FM after NaOCl sedimentation compared to 96.7% and 95.9% for direct LED-FM (P<0.01) and direct ZN (P<0.01), respectively. Inter-reading agreement (kappa = 0.7) and technicians' acceptability were good.<h4>Conclusion</h4>NaOCl sedimentation did not improve the performance of LED-FM in the diagnosis of pulmonary TB at peripheral health service level.Maryline BonnetLaramie GagnidzePhilippe J GuerinLaurence BonteAndrew RamsayWillie GithuiFrancis VarainePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 5, p e20175 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maryline Bonnet Laramie Gagnidze Philippe J Guerin Laurence Bonte Andrew Ramsay Willie Githui Francis Varaine Evaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.
description	<h4>Background</h4>Sputum microscopy is the only diagnostic for tuberculosis (TB) available at peripheral levels of health service in resource-poor countries. Its sensitivity is reduced in high HIV-prevalence settings. Sodium hypochlorite (NaOCl) specimen sedimentation prior microscopy and light-emitting diode (LED)-fluorescence microscopy (FM) can individually improve performance of microscopy. This study aimed to evaluate the performance of combined LED-FM and NaOCl sputum sedimentation for TB detection at peripheral level of health services.<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 consecutive TB suspects. Smears were prepared and stained with auramine O and Ziehl-Neelsen (ZN) methods. Bleach (3.5%) was added to the remaining specimen before overnight sedimentation at room temperature. Auramine O staining was performed on smears of sediment. A 4(th) specimen was collected for TB culture. Auramine smears were read under the same microscope as used for ZN smears, but equipped with the LED FluoLED™ fluorescence illuminator.<h4>Results</h4>497 patients were included, and 1394 specimens collected. The yield of positive specimen was significantly increased after NaOCl sedimentation (24.9%) compared to direct LED-FM (20.6%) and direct ZN (20.3%). In detecting smear-positive patients, sensitivity was 78.5% for LED-FM after NaOCl sedimentation compared to 73.2% and 72.0% for direct LED-FM (P = 0.06) and direct ZN (P = 0.06), respectively. Specificity was 87.8% for LED-FM after NaOCl sedimentation compared to 96.7% and 95.9% for direct LED-FM (P<0.01) and direct ZN (P<0.01), respectively. Inter-reading agreement (kappa = 0.7) and technicians' acceptability were good.<h4>Conclusion</h4>NaOCl sedimentation did not improve the performance of LED-FM in the diagnosis of pulmonary TB at peripheral health service level.
format	article
author	Maryline Bonnet Laramie Gagnidze Philippe J Guerin Laurence Bonte Andrew Ramsay Willie Githui Francis Varaine
author_facet	Maryline Bonnet Laramie Gagnidze Philippe J Guerin Laurence Bonte Andrew Ramsay Willie Githui Francis Varaine
author_sort	Maryline Bonnet
title	Evaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.
title_short	Evaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.
title_full	Evaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.
title_fullStr	Evaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.
title_full_unstemmed	Evaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.
title_sort	evaluation of combined led-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/73673771b07547ee996781920b41845e
work_keys_str_mv	AT marylinebonnet evaluationofcombinedledfluorescencemicroscopyandbleachsedimentationfordiagnosisoftuberculosisatperipheralhealthservicelevel AT laramiegagnidze evaluationofcombinedledfluorescencemicroscopyandbleachsedimentationfordiagnosisoftuberculosisatperipheralhealthservicelevel AT philippejguerin evaluationofcombinedledfluorescencemicroscopyandbleachsedimentationfordiagnosisoftuberculosisatperipheralhealthservicelevel AT laurencebonte evaluationofcombinedledfluorescencemicroscopyandbleachsedimentationfordiagnosisoftuberculosisatperipheralhealthservicelevel AT andrewramsay evaluationofcombinedledfluorescencemicroscopyandbleachsedimentationfordiagnosisoftuberculosisatperipheralhealthservicelevel AT williegithui evaluationofcombinedledfluorescencemicroscopyandbleachsedimentationfordiagnosisoftuberculosisatperipheralhealthservicelevel AT francisvaraine evaluationofcombinedledfluorescencemicroscopyandbleachsedimentationfordiagnosisoftuberculosisatperipheralhealthservicelevel
_version_	1718424235414650880

Evaluation of combined LED-fluorescence microscopy and bleach sedimentation for diagnosis of tuberculosis at peripheral health service level.

Ejemplares similares