Investing time in microscopy: an opportunity to optimise smear-based case detection of tuberculosis

Cambanis, A., Ramsay, Andrew, Wirkom, V., Tata, E. and Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 (2007) 'Investing time in microscopy: an opportunity to optimise smear-based case detection of tuberculosis'. International Journal of Tuberculosis and Lung Disease, Vol 11, Issue 1, pp. 40-45.

Full text not available from this repository.

Abstract

SETTING: St. Elizabeth Hospital, rural North-west Cameroon, an area with high tuberculosis (TB) and human immunodeficiency virus (HIV) incidence.
OBJECTIVE: To measure the time spent during routine sputum smear microscopy and assess whether reexamining slides for 10 min translates into higher case detection of smear-positive cases.
DESIGN: A prospective observational study over a 6-month period with three components: 1) timing of routine sputum smear examination; 2) blinded reexamination of all slides for 10 min and results compared with initial readings; and 3) blinded re-examination, by the original microscopists, of a portion of false-negative slides mixed with true negatives for 10 min.
RESULTS: A total of 204 patients submitted 612 sputum specimens for screening. The median routine examination time was 2 min 6 seconds (interquartile range 1:30-2:30). A 10 min examination significantly increased the number of positive smears from 82 to 116 (P = 0.0083), and overall case detection from 28 to 48 patients (P = 0.011). On review by the original readers, more than half of the false-negative slides were reported as positive after 10 min. CONCLUSION: Sputum smear microscopy has low sensitivity if performed too quickly, and 10 min re-examination significantly increases case detection. Ensuring that smears are examined for the recommended duration may be a simple and low-cost way to improve case detection.

Item Type:	Article
Uncontrolled Keywords:	tuberculosis case finding diagnosis smear-positive pulmonary sputum smear microscopy pulmonary tuberculosis hiv countries district malawi era
Subjects:	QY Clinical Pathology > Diagnostic Tests > QY 120 Sputum QY Clinical Pathology > Diagnostic Tests > QY 250 Immunodiagnostic tests QY Clinical Pathology > QY 4 General works WB Practice of Medicine > Diagnosis > General Diagnosis > WB 200 Physical diagnosis (General) WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General) WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis WF Respiratory System > Tuberculosis > WF 300 Pulmonary tuberculosis
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group Groups (2002 - 2012) > Clinical Group
Depositing User:	Ms Julia Martin
Date Deposited:	22 Sep 2010 15:31
Last Modified:	06 Feb 2018 13:01
URI:	https://archive.lstmed.ac.uk/id/eprint/1175

Statistics

View details

Actions (login required)

Edit Item