Same day sputum smear microscopy approach with modified ZN staining for the diagnosis of pulmonary tuberculosis in a microscopy centre at Rajahmundry

Chandra, T Jaya; Raj, RS; Sharma, YV

doi:10.4103/0255-0857.129801

Cited by 18 publications

(28 citation statements)

References 5 publications

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“…In the current study, near to 3% of morning sputum microscopy results had incremental yields from the two spot (SS) sample, which was higher than 0.0% (no) incremental yields reported in South Western Uganda, 0.29% reported in India and 0.37% reported Rajahmundry India [9,11,12]. The incremental yield difference among serials of sputum samples might be related to many factors including: Instruction given to patients to submit quality and adequacy of sputum samples, time of sputum collection (the bacillary load increase in sputum spout out in the early morning), patient understanding how to collect quality of sputum samples and professional exercise on the way to guide and explain the quality of sputum submit for diagnosis and testing performed on good quality of sputum may impacts on yield of sputum microscopy diagnostic.…”

Section: Discussioncontrasting

confidence: 74%

Diagnostic Yield of Serial Sputum Smear Microscopy Examination at Different Institutional Settings

Desalegn¹

2018

J Trop Dis

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Introduction:Number of samples and time of sputum collection has a great impact on the positivity yield of sputum smear microscopy examination. However, the impact is not yet extensively studied in Ethiopia. Therefore, the aim of this study was to assess the serials sputum sample collection impacts on the diagnostic yield of smear microscopy examination in Ethiopia at variation at different institutional settings.Methods: Institution based retrospective cohort study was conducted from October 2011 to March 2016. Two thousand four hundred sixty-three sputum smear microscopy positive result were reviewed from TB patient records. The collected data were computerized using Epi-info software and analyzed using SPSS version 20 software. Numerical summaries were used to describe the positivity yield of spot, morning and spot (SMS) sputum smear microscopy examination. Results:Of 2463 sputum smear-positive TB cases, 2384 (96.8%), 2458 (99.8%) and 2394 (97.2%) were detected by the first spot, morning and second spot sputum smear microscopy diagnosis, respectively. On the other hand, morning sputum smear results had the incremental yield of 74 (3.0%) and 64 (2.6%) from first spot sample and second spot sample, respectively. The results of 1892 (76.8%) TB cases were in agreement (detected) by three consecutive sputum specimen (SMS). Conclusion:The three consecutive sputum smear microscopy examination had 3% incremental yield compare to spot-spot (SS). The hospitals were participating in International External Quality Assurance Schemes (IEQAS) had better incremental (increased) yield in both SMS and SS approach compared to the health centers. Hence, strong TB quality assurances systems should be implemented in respective health facilities before practicing two spots (SS) sputum smear microscopy diagnostic approach as routine to TB laboratory diagnostic method.Studies show that SS can detect the vast majority (95%-98%) of smear-positive TB patients. However, this might not be true in all setting, moreover, we are not aware of any published study in Addis Ababa targeting the diagnostic yield of spot and morning sputum samples. Therefore, this study was designed to assess the diagnostic J o u rn al of Tr o p ic a l Disease s & P u bl ic He a lt h

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Section: Discussioncontrasting

confidence: 74%

Diagnostic Yield of Serial Sputum Smear Microscopy Examination at Different Institutional Settings

Desalegn¹

2018

J Trop Dis

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“…Most of the studies conducted hitherto have been under trial conditions and there is a lack of evidence from routine programme settings [7–10] and limited, conflicting information from India. A study from South India showed that same day microscopy was as effective as the conventional strategy [11]; whereas another study from North India showed that same day microscopy missed a considerable number of smear positive TB patients [12]. Both the studies were conducted in tertiary care hospitals with a limited sample size and were not representative of routine programme conditions.…”

Section: Introductionmentioning

confidence: 99%

Comparing Same Day Sputum Microscopy with Conventional Sputum Microscopy for the Diagnosis of Tuberculosis – Chhattisgarh, India

Nayak

Kumar²,

Claassens

et al. 2013

PLoS ONE

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BackgroundThe World Health Organization (WHO) recommends same day sputum microscopy (spot-spot) in preference to conventional strategy (spot-morning) for the diagnosis of smear positive tuberculosis with the view that completing diagnosis on a single day may be more convenient to the patients and reduce pre-treatment losses to follow-up.MethodsWe conducted a cross-sectional study in seven selected district level hospitals of Chhattisgarh State, India. During October 2012 – March 2013, two sputum specimens (spot-early morning) were collected from consecutively enrolled adult (≥18 years) presumptive TB patients as per current national guidelines. In addition, a second sample was collected (one hour after the collection of first spot sample) from the same patients. All the samples were examined by ziehl-Neelsen (ZN) microscopy. McNemar’s test was used to compare statistical differences in the proportion smear positive between the two approaches (spot-spot versus spot-morning).ResultsOf 2551 presumptive TB patients, 69% were male. All patients provided the first spot specimen, 2361 (93%) provided the second spot specimen, and 2435 (96%) provided an early morning specimen. 72% of specimens were mucopurulent in conventional strategy as compared to 60% in same day strategy. The proportion of smear-positive patients diagnosed by same day microscopy was 14%, as compared to 17% by the conventional method (p<0.001). A total of 73 (16.9%) potential cases were missed by the same day method compared to only 2 (0.5%) by the conventional method.ConclusionSame-day microscopy method missed 17% of smear-positive cases and contrary to prior perception, did not increase the proportion of suspects providing the second sample. These findings call for an urgent need to revisit the WHO recommendation of switching to same-day diagnosis over the current policy.

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“…Inspite of the availability of various techniques such as culture, molecular techniques, serodiagnostic methods, in this study, ZN staining was used to stain the sputum smears. LED fluorescent staining is a rapid, sensitive technique compared to ZN technique [1,2,11]. But by considering the advantages such as rapidity, ease in the technique, ZN staining was used in the current study to stain the sputum smears.…”

Section: Resultsmentioning

confidence: 99%

A study to find the correlation between ABO blood group and pulmonary tuberculosis

Dhanalakshmi

Chandra

2019

Trop J Pathol Microbiol

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Introduction: Studies regarding pulmonary tuberculosis (PT) and blood group correlations were reported from different parts of globe. But there was huge disparity. Hence a study was conducted to find the relation between PT and ABO Rh blood group. Materials and Methods: Individuals with signs and symptoms suggestive of PT were included in the study. Two spot sputum samples were collected, sputum smears were stained by ZN staining. Simultaneously, ABO blood grouping and Rh typing was done for all the participants by slide agglutination test. P value of <0.05 was considered statistically significant. All the smear positive cases were included in test group. Results: During the study period, total 421 participants were included in the study the smear positivity was 64 (14.6%). In the test group, 2.2% were A+, 0.45% were A-; statistically there was no significant difference; 4.3% were B+, 0.9% were B-statistically there was no significant difference. Whereas 1.1% were AB+ and 0.45% were AB-; statistically there was no significant difference and 3.6% were O+, 1.4% were O-; statistically there was no significant difference. Conclusion: Present study showed that there was no significant association between blood groups and PT. Studies with large sample size for long time is recommended.

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Same day sputum smear microscopy approach with modified ZN staining for the diagnosis of pulmonary tuberculosis in a microscopy centre at Rajahmundry

Abstract: Diagnosis of lung tuberculosis is possible with two spot sputum samples with modified ZN staining.

Cited by 18 publications

References 5 publications

Diagnostic Yield of Serial Sputum Smear Microscopy Examination at Different Institutional Settings

Diagnostic Yield of Serial Sputum Smear Microscopy Examination at Different Institutional Settings

Comparing Same Day Sputum Microscopy with Conventional Sputum Microscopy for the Diagnosis of Tuberculosis – Chhattisgarh, India

A study to find the correlation between ABO blood group and pulmonary tuberculosis

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