Comparison of Light-Emitting Diode Fluorescent Microscopy Against Bright-Field Microscopy and JD-TB-Antigen Test for the Diagnosis of Pulmonary Tuberculosis
American Journal of Internal Medicine
Volume 5, Issue 5, September 2017, Pages: 105-111
Received: Nov. 30, 2016;
Accepted: Dec. 12, 2016;
Published: Oct. 26, 2017
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Boja Dufera Taddese, Addis Ababa Health Research and Laboratory, Addis Ababa, Ethiopia
Abraham Tesfaye Bika, Addis Ababa Health Research and Laboratory, Addis Ababa, Ethiopia; College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Abay Sisay Misganaw, Columbia University's Mailman School of Public Health, International Center for AIDS Care and Treatment Program(ICAP), Addis Ababa, Ethiopia
Silvia Blanco Palencia, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Chala Chaburte Galata, Faculty of Veterinary Medicine, Addis Ababa University, Bishoftu, Ethiopia
Abiy Aklilu Teferra, Ethiopian Conformity Assessment Enterprise, Addis Ababa, Ethiopia
Bright field microscopy using Ziehl-Neelsen (ZN) stained smear has been the major diagnostic technique for the diagnosis of pulmonary tuberculosis and treatment initiation in resource limited settings. However, it has its own limitation in terms of its sensitivity. Various reports have shown superior sensitivity of light emitting-diode fluorescent microscopy (LED-FM) and comparable specificity to bright field microscopy. The aim of the study was to compare the results of Auramine O-stained sputum smears by LED-FM against Ziehl-Neelsen stained sputum smears and JD-TB-Antigen test using TB culture as a reference test. A cross-sectional study was conducted in Southern Nations and Nationality People Regions (SNNPR) of Ethiopia from September 2013 to November 2014. A total of 248 sputum samples were collected from different Health Centers and Hospitals of the study area, analyzed by LED-FM and ZN stained bright field microscopy. The sensitivity, specificity, positive and negative predictive value were 66.12%, 95.28%, 93.02% and 74.69% for ZN stained microscopy; 81.82%, 93.70%, 92.50% and 98.35% for LED–FM, and 58.33%, 63.27%, 53.85% and 67.39% for JD-TB-Antigen test, respectively. The correlation between LED-FM, ZN and culture have shown statistically significant (p<0.001). The sensitivity of LED-FM is better than ZN-stained bright field microscopy. It is also easy to perform, save time and better choice for sputum microscopic examination. The performance of JD-TB-Antigen test was very low for the diagnosis of tuberculosis in sputum specimens. Therefore, further study should be done to use JD-TB-Ag test for diagnosis of pulmonary tuberculosis
Boja Dufera Taddese,
Abraham Tesfaye Bika,
Abay Sisay Misganaw,
Silvia Blanco Palencia,
Chala Chaburte Galata,
Abiy Aklilu Teferra,
Comparison of Light-Emitting Diode Fluorescent Microscopy Against Bright-Field Microscopy and JD-TB-Antigen Test for the Diagnosis of Pulmonary Tuberculosis, American Journal of Internal Medicine.
Vol. 5, No. 5,
2017, pp. 105-111.
FMoH. guide lines for clinical and programmatic managements of TB, TB/HIV and Leprosy in Ethiopia 5th edn 2013.
Parsons, L. M., Somoskövi, A., Gutierrez, C., Lee, E., Paramasivan, C. N., Abimiku, A., etal. Laboratory diagnosis of tuberculosis in resource-poor countries: challenges and opportunities. Clin. Microbiol. Rev. 2010: 24: 314-345.
FMoH. National HIV/AIDS Prevention Control Office Technical Document for the AIDS in Ethiopia 6th Report. 2009.
WHO. Global tuberculosis report. Geneva, Switzerland. 2013.
Mathur, M. L., Gaur J., Sharma R. and Solanki, A. Rapid culture of Mycobacterium tuberculosis on blood agar in resource limited setting. Dan Med Bull. 2009: 56: 208-210.
Marais, B. J., Brittle, W. and Painczyk, K. Use of light-emitting diode fluorescence microscopy to detect acid-fast bacilli in sputum. Clin Infect Dis. 2008: 47: 203–207.
Steingart, K. R., and Henry, M. N. V. Fluorescence versus conventional sputum smear-microscopy for tuberculosis: a systematic review. Lancet Infect Dis. 2006: 6: 570–581.
Van Deun, A., Chonde, T. M., Gumusboga, M., Rienthong, S. Performance and acceptability of the Fluo LED Easy module for tuberculosis fluorescence microscopy. Int J Tuberc Lung Dis. 2008: 12: 1009–1014.6.
WHO. Laboratory services in tuberculosis control. Geneva, Switzerland, 1998.
Albert, H., Manabe, Y., Lukyamuzi, G., Ademun, H,. Mukkada, S. Nyesiga, B., Joloba, M., Paramasivan, C. N. and Perkins, M. D. Performance of Three LED-Based Fluorescence Microscopy Systems for Detection of Tuberculosis in Uganda. PLoS ONE 2010: 5: 1-7.
Bonnet, M., Gagnidze, L., Githui, W., Guerin,. P. J., Bonte, L., Varaine.F.e tal. A. Performance of LED-Based Fluorescence Microscopy to Diagnose Tuberculosis in a Peripheral Health Centre in Nairobi. PLoS ONE. 2011: 6: 1-6.
Khatun, Z., Hossain, M. S., Roy, C. K., Sultana, T., Rahman, Azad, S. e tal. Light Emitting Diode (LED) Fluorescent Microscopy: a Milestone in the Detection of Paucibacillary Mycobacterium in Case of Pulmonary Tuberculosis. Bangladesh Medical Journal. 2011: 40: 1-22-26.
Cuevas, L. E., Al-Sonboli, N., Lawson, L., Yassin, M. A., Arbide, I., Al-Aghbari, N., et al. A. LED Fluorescence Microscopy for the Diagnosis of Pulmonary Tuberculosis: A Multi-Country Cross-Sectional Evaluation. 2011: 8: 1-10.
Rahman, F., Munshi, S. K., Mostofa Kamal S. M., MatiurRahman, S. M., Rahman, M. M. and Noor, R. Comparison of Different Microscopic Methods with Conventional TB Culture. S. J. Microbiol. 2011: 1: 2074-5356.
Cattamachi, A., Davis, J. L., Worodria, W., Boon, S., Yoo, S., Matovu, J., e tal. Sensitivity and Specificity of Fluorescence Microscopy for Diagnosing Pulmonary Tuberculosis in a High HIV Prevalence Setting. Int J Tuberc Lung Dis. 2009: 13: 1130–1136.
WHO. Commercial Sero diagnostic Tests for Diagnosis of Tuberculosis. 2010.
Alifano, M., Pascalis, R. D., Sofia, M., Faraone, S., Pezzo, M., and Covelli, I. Detection of IgG and IgA against the mycobacterial antigen A-60 in patients with extrapulmonary tuberculosis. Thorax. 1998: 53: 377–380.
Nanta, S., Kantipong, P., Pathipvanich, P., Ruengorn, C., Tawichasri, C.andPatumanond, J. Diagnostic value of an immunochromatographic test over clinical predictors for tuberculosis in HIV patients. Clinical Epidemiology. 2011: 3: 237–244.
Lee, J., Yu, F., Lin, M., Huang, G., Chang, C., Cheng, C., and Wang. G. Utility of Immunochromatographic Assay for Detecting MycobacteriumTuberculosis from Positive BACTEC MGIT 960 Cultures. J Biomed Lab Sci. 2010: 22: 64-68.