| dc.contributor |
Epicentre, Paris, France. maryline.bonnet@geneva.msf.org |
|
| dc.creator |
Bonnet, M |
|
| dc.creator |
Ramsay, A |
|
| dc.creator |
Gagnidze, L |
|
| dc.creator |
Githui, W |
|
| dc.creator |
Guerin, P J J |
|
| dc.creator |
Varaine, F |
|
| dc.date |
2007-09 |
|
| dc.date.accessioned |
2017-01-31T07:10:17Z |
|
| dc.date.available |
2017-01-31T07:10:17Z |
|
| dc.identifier |
Reducing the Number of Sputum Samples Examined and Thresholds for Positivity: An Opportunity to Optimise Smear Microscopy. 2007, 11 (9):953-8 Int. J. Tuberc. Lung Dis. |
|
| dc.identifier |
1027-3719 |
|
| dc.identifier |
17705971 |
|
| dc.identifier |
http://hdl.handle.net/10144/20674 |
|
| dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/20674 |
|
| dc.identifier |
International Journal of Tuberculosis and Lung Disease |
|
| dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/20674 |
|
| dc.description |
SETTING: Urban health clinic, Nairobi. OBJECTIVE: To evaluate the impact on tuberculosis (TB) case detection and laboratory workload of reducing the number of sputum smears examined and thresholds for diagnosing positive smears and positive cases. DESIGN: In this prospective study, three Ziehl-Neelsen stained sputum smears from consecutive pulmonary TB suspects were examined blind. The standard approach (A), > or = 2 positive smears out of 3, using a cut-off of 10 acid-fast bacilli (AFB)/100 high-power fields (HPF), was compared with approaches B, > or = 2 positive smears (> or = 4 AFB/100 HPF) out of 3, one of which is > or = 10 AFB/100 HPF; C, > or = 2 positive smears (> or = 4 AFB/100 HPF) out of 3; D, > or = 1 positive smear (> or = 10 AFB/100 HPF) out of 2; and E, > or = 1 positive smear (> or = 4 AFB/100 HPF) out of 2. The microscopy gold standard was detection of at least one positive smear (> or = 4 AFB/100 HPF) out of 3. RESULTS: Among 644 TB suspects, the alternative approaches detected from 114 (17.7%) (approach B) to 123 cases (19.1%) (approach E) compared to 105 cases (16.3%) for approach A (P < 0.005). Sensitivity ranged between 82.0% (105/128) for A and 96.1% (123/128) for E. The single positive smear approaches reduced the number of smears by 36% compared to approach A. CONCLUSION: Reducing the number of specimens and the positivity threshold to define a positive case increased the sensitivity of microscopy and reduced laboratory workload. |
|
| dc.language |
en |
|
| dc.publisher |
International Union Against TB and Lung Disease |
|
| dc.relation |
http://www.ingentaconnect.com/content/iuatld/ijtld |
|
| dc.rights |
Archived on this site with the kind permission of the International Union Against TB and Lung Disease, http://www.iuatld.org |
|
| dc.title |
Reducing the Number of Sputum Samples Examined and Thresholds for Positivity: An Opportunity to Optimise Smear Microscopy. |
|