Concordance of two sputum smear microscopy for diagnosis of presumptive pulmonary tuberculosis in a tertiary care hospital

Background: Under revised National tuberculosis control program two sputum samples are to be collected for diagnosis of presumptive pulmonary tuberculosis case. The objective of this study is to find the concordance of both sputum smear microscopy samples at a tertiary care hospital. Methods: Hospital based record was collected from designated microscopy center laboratory register. The data collected were from January 2015 to November 2016. Results: A total of 2117 paired of sputum sample were collected for the year 2015-16 in one of the DMC of a tertiary care hospital. A total of 183 patient (at least one sputum sample) were positive (8.64%) and 1934 were both negative. Among the positive sample concordance for both spot and morning samples were 89% (163/183) and discordance where spot sample positive and morning sample negative was 4.91% (9/183) and where spot sample negative and morning sample positive was 6.01% (11/183). Overall discordance between spot and morning samples were only 0.94% (20/2117). Conclusions: There is a good concordance of two sputum samples. Discordance of two sputum samples were <1% in a tertiary care hospital. One sample may be sufficient for operational purpose for diagnosis of pulmonary Tb. But to have a robust recommendation a RCT will be required to see the extent of discordance by ruling out bias in sputum smear examination.

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A Study on Delay in Giving the Early Morning Sample and Barriers in Accessing Sputum Smear Microscopy Services at Tertiary Care Hospital

Indian Journal of Public Health Research & Development ◽

10.37506/v11/i2/2020/ijphrd/194933 ◽

2020 ◽

Vol 11 (2) ◽

pp. 922

Author(s):

Abhishek Chauhan ◽

Jai Kishan ◽

Sameer Singhal ◽

Achhar Singh ◽

Aditi Gupta

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Early Morning ◽

Sputum Smear ◽

Smear Microscopy ◽

Care Hospital ◽

Sputum Smear Microscopy

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DIAGNOSTIC PERFORMANCE OF ZIEHL-NEELSEN & CBNAAT TECHNIQUES IN PULMONARY TUBERCULOSIS, A RETROSPECTIVE ANALYSIS AT TERTIARY CARE HOSPITAL IN JHALAWAR, RAJASTHAN.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i1.1633 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Shilpi Hora ◽

Neeraj Raman ◽

Mukesh Kumar ◽

Needa Saneef

Keyword(s):

Pulmonary Tuberculosis ◽

Tertiary Care Hospital ◽

Point Of Care ◽

Tertiary Care ◽

Nucleic Acid Amplification ◽

Smear Microscopy ◽

Care Hospital ◽

Age Group ◽

Hands On ◽

High Incidence

Introduction: Tuberculosis (TB) remains a leading cause of death among infectious diseases worldwide. The advent of the CBNAAT was a revolution in the diagnosis of tuberculosis, especially with high incidence and resource poor regions. It can be used close to the point of care by operators with minimal technical expertise, enabling diagnosis of TB and rifampicin Resistance (RIF) concurrently using unprocessed clinical specimens, in less than 2h. Aim: To evaluate the diagnostic performances of Ziehl-Neelsen & CBNAAT techniques in detection of Pulmonary Tuberculosis. Materials and Methods: We retrospectively reviewed the 2414 sputum samples of suspected pulmonary TB. Sputum samples were subjected for ZN staining and CBNAAT.RIF resistance was detected by CBNAAT. Results: Out of 2414 samples, 751 sputum samples were positive by smear microscopy. 1127 Samples were confirmed positive by CBNAAT examination. Majority of cases, 43.57% were in 21-40 yrs age group.24.40% were females and 75.59% were males. Sensitivity of CBNAAT was 100% for sputum positive cases and sensitivity was 22.6% for sputum negative cases. Overall RIF resistance was detected in 49 (4.4%) cases in present study. Conclusion: CBNAAT provide sensitive detection of tuberculosis and rifampicin resistance directly from untreated sputum in less than 2 hours with minimal hands-on time. Keywords: Cartridge-based nucleic acid amplification tests (CBNAAT), Rifampicin(RIF)

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Improved Diagnosis of Pulmonary Tuberculosis using Bleach (Sodium hypochlorite) Concentration Technique at Tertiary Care Hospital

Nepal Journal of Health Sciences ◽

10.3126/njhs.v1i2.42371 ◽

2021 ◽

Vol 1 (2) ◽

pp. 15-22

Author(s):

Saroj Kumar Thakur ◽

Vishvesh Prakashchandra Bansal ◽

Jyotsna Mishra ◽

M.P. Bansal ◽

Iswari Sapkota ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Sodium Hypochlorite ◽

Direct Method ◽

Tertiary Care ◽

Sputum Smear ◽

Smear Microscopy ◽

Care Hospital ◽

Case Detection ◽

Acid Fast Bacilli ◽

Concentration Method

Introduction: In the Revised National Tuberculosis Control Program (RNTCP), microscopic examination of sputum for acid-fast bacilli (AFB) is currently the backbone for the diagnosis of pulmonary tuberculosis. Studies have shown liquefaction and concentration of sputum by 5% sodium hypochlorite is useful in providing increased sensitivity and safety for the handling of specimens. Objective: To assess the utility of the 5% Sodium hypochlorite concentration method in increasing the sensitivity of smear microscopy for detection of AFB for diagnosis of pulmonary tuberculosis. Methods: The study included a total of 1000 sputum samples from 500 patients with suspected pulmonary tuberculosis. Direct smears were prepared from the sputum samples as per RNTCP guidelines. The remaining sputum was used for bleach concentration and smears prepared from the concentrated material. Both smears were stained by Ziehl-Neelsen staining and screened for acid-fast bacilli and graded according to the RNTCP guidelines. Results: A total of 158 samples (15.8%) from 89 patients were positive by a routine direct method whereas by concentration method 236 samples (23.6%) from 143 patients were found positive diagnosing additional 54 patients. The gain in sputum smear positivity of 7.8% over the routine method is highly significant (p=0.0000, χ2= 270) with a 10.8% increase in case detection. Conclusions: Improvement in the sensitivity of smears microscopy will be useful in case detection of tuberculosis especially in resource-poor countries. The increased positivity of microscopy by bleach method indicates that would prove useful if included in the RNTCP to improve case detection. Keywords: Concentration; smear positivity; sodium hypochlorite; tuberculosis.

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