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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Comparing Same Day Sputum Microscopy with Conventional Sputum Microscopy for the Diagnosis of Tuberculosis - Chhattisgarh, India
PLoS ONE, Volume 8, No. 9, Article e74964, Year 2013
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Description
Background:The 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.Methods:We 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).Results:Of 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.Conclusion:Same-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. © 2013 NAYAK et al.
Authors & Co-Authors
Nayak, Priyakanta
Switzerland, Geneva
Organisation Mondiale de la Santé
Kumar, Ajay Madhugiri Venkatachalaiah
India, New Delhi
South-east Asia Regional Office
Claassens, Mareli Misha
South Africa, Stellenbosch
Stellenbosch University
Enarson, Donald A.
India, New Delhi
South-east Asia Regional Office
Satyanarayana, Srinath
India, New Delhi
South-east Asia Regional Office
Kundu, Debashish
Switzerland, Geneva
Organisation Mondiale de la Santé
Khaparde, Kshitij
Switzerland, Geneva
Organisation Mondiale de la Santé
Agrawal, Tarun K.
India, Raipur
State Tuberculosis Office
Dapkekar, Shankar
Switzerland, Geneva
Organisation Mondiale de la Santé
Chandraker, Sachin
India, Raipur
Intermediate Reference Laboratory
Nair, Sreenivas Achuthan
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 20
Authors: 11
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pone.0074964
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Participants Gender
Male