scholarly journals Ziehl Neelsen vs. Auramine staining technique for detection of acid fast bacilli

2018 ◽  
Vol 1 (1) ◽  
pp. 59-66
Author(s):  
Rajendra Gurung ◽  
R Shrestha ◽  
N Poudyal ◽  
SK Bhattacharya

Background: The culture and molecular test are the best methods for isolation and identification of Mycobacterium tuberculosis in developed countries. But, in developing countries like Nepal with a significant number of tuberculosis (TB) cases and limited resources, the diagnosis of TB relies primarily on smear microscopy for Acid fast bacilli (AFB).Objective: To compare the results of direct sputum examination for AFB stained by Ziehl Neelsen and Auramine technique.Method: Cross sectional comparative study was conducted in tuberculosis research laboratory, BPKIHS from April to June 2013. A total of 100 sputum samples were collected randomly. Four slides were smeared and labeled for each as neat ZN, neat Auramine, concentrate ZN and concentrate Auramine. Slides were processed as per WHO laboratory guidelines.Results: The findings of this study revealed that 3% positive with neat Auramine was negative for ZN stain. Similarly, 5% positive cases with Auramine concentrate were negative with ZN concentrate technique. Auramine stain was able to detect all ZN positive as positive but only 83 cases were detected as negative among 88 case of ZN negative. Both concentration techniques showed 12% of positive with significant relationship. With this; Auramine showed 100% sensitivity, 94.6% specificity, positive predictive values and negative predictive values 70.5, 100% respectively.Conclusion: Auramine stain stands efficient on comparison and can be used as an alternative to ZN stain, with added value of allowing a large number of sputum specimens to be examined in a given time as low power is used for examination.Journal of BP Koirala Institute of Health Sciences, Vol. 1, No. 1, 2018, Page: 59-66

Author(s):  
Charlotte E.M. ten Broeke ◽  
Jelle C.L. Himmelreich ◽  
Jochen W.L. Cals ◽  
Wim A.M. Lucassen ◽  
Ralf E. Harskamp

Abstract Aim: To validate the Roth score as a triage tool for detecting hypoxaemia. Backgrounds: The virtual assessment of patients has become increasingly important during the corona virus disease (COVID-19) pandemic, but has limitations as to the evaluation of deteriorating respiratory function. This study presents data on the validity of the Roth score as a triage tool for detecting hypoxaemia remotely in potential COVID-19 patients in general practice. Methods: This cross-sectional validation study was conducted in Dutch general practice. Patients aged ≥18 with suspected or confirmed COVID-19 were asked to rapidly count from 1 to 30 in a single breath. The Roth score involves the highest number counted during exhalation (counting number) and the time taken to reach the maximal count (counting time). Outcome measures were (1) the correlation between both Roth score measurements and simultaneous pulse oximetry (SpO2) on room air and (2) discrimination (c-statistic), sensitivity, specificity and predictive values of the Roth score for detecting hypoxaemia (SpO2 < 95%). Findings: A total of 33 physicians enrolled 105 patients (52.4% female, mean age of 52.6 ± 20.4 years). A positive correlation was found between counting number and SpO2 (rs = 0.44, P < 0.001), whereas only a weak correlation was found between counting time and SpO2 (rs = 0.15, P = 0.14). Discrimination for hypoxaemia was higher for counting number [c-statistic 0.91 (95% CI: 0.85–0.96)] than for counting time [c-statistic 0.77 (95% CI: 0.62–0.93)]. Optimal diagnostic performance was found at a counting number of 20, with a sensitivity of 93.3% (95% CI: 68.1–99.8) and a specificity of 77.8% (95% CI: 67.8–85.9). A counting time of 7 s showed the best sensitivity of 85.7% (95% CI: 57.2–98.2) and specificity of 81.1% (95% CI: 71.5–88.6). Conclusions: A Roth score, with an optimal counting number cut-off value of 20, maybe of added value for signalling hypoxaemia in general practice. Further external validation is warranted before recommending integration in telephone triage.


Author(s):  
Iqbal Rashid ◽  
Langalibalele H. Mabuza ◽  
Indiran Govender ◽  
Deidre Pretorius

Background: Optimum sputum results for acid-fast bacilli (AFB) microscopy are linked to a sputum quantity of at least 5.0 mL. This study was aimed at establishing the effect of sputum quantity in the pick-up rate of AFB microscopy by comparing sputum samples of 5.0 mL and 2.0 mL.Methods: An analytical cross-sectional study was carried out at the Dr George Mukhari Hospital (DGMH) in Pretoria, South Africa, from 05 January 2007 to 04 January 2008.Two sputum samples, 5.0 mL and 2.0 mL, were collected from each of the 330 adult PTB (pulmonary tuberculosis) suspects. Fluorescence microscopy was used in the sputum analysis. The yield through microscopy of the 2.0 mL specimen versus the 5.0 mL specimen was compared and analysed, using culture results as the gold standard.Results: From a sample of 330 specimens, 77 tested AFB positive on microscopy. In the 5.0 mL samples, the sensitivity was 76.6% (95% CI, 66.0% – 84.7%), specificity 99.6% (95% CI 97.8% – 99.9%), positive predictive value (PV+) 98.3% (95% CI 91.1% – 99.7%), negative predictive value (PV-) 93.3% (95% CI 89.7% – 95.7%), the likelihood ratio (LR) for a positive microscopy 192 and the LR for a negative test was 0.23. In the 2.0 mL specimens, the sensitivity was 75.3% (95% CI 64.6% – 83.6%), specificity 99.2% (95% CI 97.1% – 99.8%), positive predictive value (PV+) 96.7% (95% CI 88.6% – 99.1%), negative predictive value (PV-) 93.0% (95% CI 89.3% – 95.4%), the LR for a positive microscopy was 94 and 0.25 for a negative microscopy. There was a statistically significant association (p-value < 0.001) between the microscopy and culture tests in both the 5.0 mL and the 2.0 mL specimen categories. The strength of association between the microscopy and culture, as indicated by the kappa test was 0.83 and 0.81 in the 5.0 mL and 2.0 mL categories, respectively.Conclusion: Compared to the 2.0 mL specimen category, the yield for AFB microscopy in the 5.0 mL specimen category was consistently superior, as indicated by the higher sensitivity, specificity, predictive values and the likelihood ratios in the 5.0 mL specimen category. It is recommended that sputum specimen collection for AFB microscopy should aim for a minimum volume of 5.0 mL.


Author(s):  
Ummul Khair ◽  
Nursin Abd Kadir ◽  
Benny Rusli

Tuberculosis (TB) is a global health problem, which is the third leading cause of death of all infectious diseases aroundthe world, included Indonesia. Acid Fast Bacilli (AFB) smear and rapid molecular assay for Mycobacterium tuberculosis (MTB)are the old and new examinations required for MTB laboratory diagnosis. This study aimed to compare the performance ofMTB rapid molecular assay and AFB smear in diagnosis and screening for TB patients. This observational retrospective studyused a cross-sectional approach, with a purposive sampling technique of 559 patients with suspected TB in Labuang BajiHospital, Makassar. This study was conducted from March 2019 to June 2019 by taking data from medical records fromJanuary 2018 to December 2018 at Labuang Baji Hospital, Makassar. Three hundred and forty-nine subjects were males(62.4%), and 210 subjects were females (37.6%). This study revealed sensitivity and specificity of 98.57% and 84.96%,respectively for MTB rapid molecular assay, and 68.65% and 99.44%, respectively for AFB smear, this shows that MTB rapidmolecular assay was superior to AFB smear in diagnosing TB patients.


2021 ◽  
Vol 15 (09) ◽  
pp. 1299-1307
Author(s):  
Yared Merid ◽  
Elena Hailu ◽  
Getnet Habtamu ◽  
Melaku Tilahun ◽  
Markos Abebe ◽  
...  

Introduction: Understanding the epidemiology of tuberculosis is limited by lack of genotyping data. We sought to characterize the drug susceptibility testing patterns and genetic diversity of M. tuberculosis isolates in southern Ethiopia. Methodology: A cross-sectional study was conducted among newly diagnosed sputum smear positive patients with tuberculosis visiting nine health facilities in southern Ethiopia from June 2015 to May 2016. Three consecutive sputum samples (spot-morning-spot) per patient were examined using acid-fast bacilli smear microscopy with all smear positive specimens having acid-fast bacilli cultures performed. M. tuberculosis isolates had drug susceptibility testing performed using indirect proportion method and were genotyped with RD9 deletion analysis and spoligotyping. Mapping of strain was made using geographic information system. Results: Among 250 newly diagnosed patients with tuberculosis, 4% were HIV co-infected. All 230 isolates tested were M. tuberculosis strains belonging to three lineages: Euro-American, 187 (81%), East-African-Indian, 31 (14%), and Lineage 7 (Ethiopian lineage), 8 (4%); categorized into 63 different spoligotype patterns, of which 85% fell into 28 clusters. M. tuberculosis strains were clustered by geographic localities. The dominant spoligotypes were SIT149 (21%) and SIT53 (19%). Drug susceptibility testing found that 14% of isolates tested were resistant to > 1 first line anti- tuberculosis drugs and 11% to INH. SIT 149 was dominant among drug resistant isolates. Conclusions: The study revealed several clusters and drug resistant strains of M. tuberculosis in the study area, suggesting recent transmission including of drug resistant tuberculosis. Wider monitoring of drug susceptibility testing and geospatial analysis of transmission trends is required to control tuberculosis in southern Ethiopia.


2021 ◽  
Vol 15 (11) ◽  
pp. e0009859
Author(s):  
Hannah M. Cranford ◽  
A. Springer Browne ◽  
Karen LeCount ◽  
Tammy Anderson ◽  
Camila Hamond ◽  
...  

During 2019–2020, the Virgin Islands Department of Health investigated potential animal reservoirs of Leptospira spp., the bacteria that cause leptospirosis. In this cross-sectional study, we investigated Leptospira spp. exposure and carriage in the small Indian mongoose (Urva auropunctata, syn: Herpestes auropunctatus), an invasive animal species. This study was conducted across the three main islands of the U.S. Virgin Islands (USVI), which are St. Croix, St. Thomas, and St. John. We used the microscopic agglutination test (MAT), fluorescent antibody test (FAT), real-time polymerase chain reaction (lipl32 rt-PCR), and bacterial culture to evaluate serum and kidney specimens and compared the sensitivity, specificity, positive predictive value, and negative predictive value of these laboratory methods. Mongooses (n = 274) were live-trapped at 31 field sites in ten regions across USVI and humanely euthanized for Leptospira spp. testing. Bacterial isolates were sequenced and evaluated for species and phylogenetic analysis using the ppk gene. Anti-Leptospira spp. antibodies were detected in 34% (87/256) of mongooses. Reactions were observed with the following serogroups: Sejroe, Icterohaemorrhagiae, Pyrogenes, Mini, Cynopteri, Australis, Hebdomadis, Autumnalis, Mankarso, Pomona, and Ballum. Of the kidney specimens examined, 5.8% (16/270) were FAT-positive, 10% (27/274) were culture-positive, and 12.4% (34/274) were positive by rt-PCR. Of the Leptospira spp. isolated from mongooses, 25 were L. borgpetersenii, one was L. interrogans, and one was L. kirschneri. Positive predictive values of FAT and rt-PCR testing for predicting successful isolation of Leptospira by culture were 88% and 65%, respectively. The isolation and identification of Leptospira spp. in mongooses highlights the potential role of mongooses as a wildlife reservoir of leptospirosis; mongooses could be a source of Leptospira spp. infections for other wildlife, domestic animals, and humans.


2018 ◽  
Vol 1 (2) ◽  
pp. 89-94
Author(s):  
Intan Sari

Low Birth Weight (LBW) is an infant born with a birth weight of less than 2500 grams regardless of gestation. Birth weight is the weight of the baby weighed in 1 hour after birth. (Depkes RI, 2009). Based on WHO and UNICEF data, in 2013 about 222 million babies were born in the world, of which 16% were born with low birth weight. The percentage of LBW in developing countries is 16.5% twice that of developed countries (7%) (Scholar Unand, 2014). The purpose of this study was to determine whether there is a relationship between anemia and Smoking Habit in Pregnant Women with LBW occurrence in General Hospital Dr. Mohammad Hoesin Palembang Year 2016. This research use analytical survey method with cross sectional approach. The population in this study were all mothers who gave birth monthly in Midwifery Installation of Dr. General Hospital Mohammad Hoesin Palembang in 2016 as many as 315 respondents. The sample of this research is some of mothers who give birth enough month in Midwifery Installation of Dr. General Hospital Mohammad Hoesin Palembang Year 2016 as many as 315 respondents. ". From the results of bivariate analysis of anemic respondents with the occurrence of LBW obtained statistical test X2 count = 23.22 which means there is a significant relationship between anemia with the incidence of BBLR. Respondents smoking with the occurrence of LBWR obtained statistical test X2 count = 41.20 which means there is a relationship Meaningful between smoking and LBW incidence. From the results of this study is expected that this research can be a reference material and is a complete information and useful for the development of knowledge about LBW.


Author(s):  
Dur-e- Nishat

Background: Family medicine is a field in which complete and detailed set of healthcare services are provided to the patients and their families. In developed countries, freshly graduated students choose family medicine as a priority for their career. However, in Pakistan it is not the case. The present study is undertaken to determine the perceptions of final year medical students’ about Family Medicine as a viable career. Methods: A total number of 504 students participated in the study. This was a cross-sectional study. The study participants were in their final year of medical college. Data was collected using a preapproved questionnaire. Data was entered and analyzed via SPSS version 17 and Chi-Square test was used post-stratification. Results: Only 14.3% (n=72) medical students had heard about Family Medicine. Only 18% (n=92) would select family medicine as a profession. The most frequent rationale for choosing the field of Family Medicine was the variety of patients seen in general practice (55.4% n=51). Conclusion: There is a dire need to focus on increasing awareness about the field of family medicine among medical students. The students should be counseled on the advantages along with the disadvantages of choosing this field as a medical profession.


2020 ◽  
Vol 16 (3) ◽  
pp. 204-210 ◽  
Author(s):  
Asirvatham A. Robert ◽  
Mohamed A. Al Dawish

From last few years, the pervasiveness of diabetes mellitus (DM), in Saudi Arabia, is growing at a frightening rate. Overall, one-fourth of the adult population is affected by DM, which is further predicted to rise to more than double by the year 2030. The most alarming is possibly the escalation propensity of diabetes, in recent years, where a nearly ten-fold increase has been witnessed over the past thirty years in Saudi Arabia. However, the number of research arbitrations on the prevalence and incidence of DM is woefully inadequate, as compared to developed countries. Apart from this, most of the existing research data carried out in Saudi Arabia is cross-sectional, with small sample sizes, which most often involve only certain parts of the country. Consequently, the present scenario demands more multidimensional and multisectoral research to strengthen the evidence base and to accumulate greater knowledge as a basis for measures and programmes to confront diabetes and its complications. Thus, the present report makes an attempt to depict the current trend of diabetes as well as intends to put forward essential measures for controlling diabetes in Saudi Arabia.


2020 ◽  
Vol 42 (1) ◽  
pp. 110-123
Author(s):  
Mohammad Issam Diab ◽  
Angham Ibrahim ◽  
Oraib Abdallah ◽  
Alla El-Awaisi ◽  
Monica Zolezzi ◽  
...  

AbstractBackground Pharmacists in many developed countries have been granted prescribing authorities under what is known as “non-medical prescribing” or “pharmacist prescribing”. However, such prescribing privileges are not available in many developing countries. Objective The objective of this study was to determine the perspectives of future pharmacists (recent pharmacy graduates and pharmacy students) on pharmacist prescribing and its potential implementation in Qatar. Methods A convergent parallel mixed-methods design was used: (1) a cross-sectional survey using a pre-tested questionnaire and; (2) focus group discussions to allow for an in-depth understanding of the issue, with a focus on pharmacists prescribing competencies as well as barriers for its implementation. Main outcome measures Future pharmacists’ perspectives and attitudes towards pharmacist prescribing in Qatar. Results The majority of the respondents (94.4%) indicated awareness of the prescribing competency related to selecting treatment options. Furthermore, the majority (92.4%) believed that pharmacists should undergo prescribing training and accreditation before been legally allowed to prescribe, a point that was reiterated in the focus group discussions. Participants generally expressed support for collaborative and supplementary prescribing models when developing prescribing frameworks for Qatar. Four categories emerged under the theme barriers to implementation of pharmacist prescribing: lack of prescribing competency, pharmacist mindset, lack of accessibility to patient records and counseling rooms, and diversity of education and training background. Conclusion The majority of recent pharmacy graduates and students were in favor of pharmacist prescribing been implemented in Qatar. However, a special training program was deemed necessary to qualify pharmacists to prescribe safely and effectively.


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