LED-Fluorescence Microscopy for Diagnosis of Pulmonary Tuberculosis under Programmatic Conditions in India

Light-emitting diode fluorescence microscopy (LED-FM) has been shown to be more sensitive than conventional bright field microscopy using Ziehl-Neelsen (ZN) stain in detecting sputum smear positive tuberculosis in controlled laboratory conditions. In 2012, Auramine O staining based LED-FM replaced c...

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Veröffentlicht in:PloS one Jg. 8; H. 10; S. e75566
Hauptverfasser: Reza, Lord Wasim, Satyanarayna, Srinath, Enarson, Donald A., Kumar, Ajay M. V., Sagili, Karuna, Kumar, Sujeet, Prabhakar, Levi Anand, Devendrappa, N. M., Pandey, Ashish, Wilson, Nevin, Chadha, Sarabjit, Thapa, Badri, Sachdeva, Kuldeep Singh, Kohli, Mohan P.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 09.10.2013
Public Library of Science (PLoS)
Schlagworte:
Acids
Adolescent
Adult
Aged
Analysis
Child
Child, Preschool
Collaboration
Colleges & universities
Control
Diagnosis
Feasibility studies
Fluorescence
Fluorescence microscopy
Health services
Hospitals
Humans
India
Infant
Infant, Newborn
Laboratories
LEDs
Light emitting diodes
Lung diseases
Medical diagnosis
Medical research
Medical schools
Microscopy
Microscopy, Fluorescence - methods
Middle Aged
Patients
Smear
Sputum
Sputum - microbiology
Staining
Stains
Stains & staining
Supervisors
Tuberculosis
Tuberculosis, Pulmonary - diagnosis
Young Adult
Zinc
India
East Asia
ISSN:1932-6203, 1932-6203
Online-Zugang:Volltext
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Zusammenfassung:Light-emitting diode fluorescence microscopy (LED-FM) has been shown to be more sensitive than conventional bright field microscopy using Ziehl-Neelsen (ZN) stain in detecting sputum smear positive tuberculosis in controlled laboratory conditions. In 2012, Auramine O staining based LED-FM replaced conventional ZN microscopy in 200 designated microscopy centres (DMC) of medical colleges operating in collaboration with India's Revised National Tuberculosis Control Programme. We aimed to assess the impact of introduction of LED-FM services on sputum smear positive case detection under program conditions. This was a before and after comparison study. In 15 randomly selected medical college DMCs, all presumptive TB patients who underwent sputum smear examination in the years 2011 (before LED-FM) and 2012 (after LED-FM) were compared. An additional 15 comparable DMCs that implemented conventional ZN sputum smear microscopy were also selected for comparison between 2011 and 2012. The proportion of presumptive TB patients (PTP)found sputum smear positive increased by 30%- from 13.6% (3432/25159) in 2011 to 17.8% (4706/26426) in 2012 (P value <0.01) in the sites that implemented LED-FM microscopy, whereas in DMCs where the ZN staining procedure is followed the proportion of sputum smear positive had remained unchanged (13.0%versus 12.6%;P value0.31). Use of LED-FM significantly increased the proportion of smear positive cases among presumptive TB patients under routine program conditions in high workload laboratories. The study provides operational evidence needed to scale-up the use of LED-FM in similar settings in India and beyond.
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Conceived and designed the experiments: LWR SS DE AK KS NW SC SK LA MK KSS AP. Performed the experiments: LWR SK NMD LA AP SS NW SC MK. Analyzed the data: LWR KS DE SS AK BT SK. Contributed reagents/materials/analysis tools: LWR AK SS NMD SK LA AP SC NW. Wrote the paper: LWR DE SS AK KS SK BT LA NMD NW SC KSS MK. Reviewed the final Manuscript: LWR DE SS AK KS SK LA NW SC KSS MK BT NMD AP.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0075566