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|Title: ||Sensitivity and specificity of fluorescence microscopy for diagnosing pulmonary tuberculosis in a high HIV prevalence setting|
|Authors: ||Cattamanchi, A.|
Davis, J. L.
Boon, Den S.
Osmond, D. H.
Hopewell, P. C.
Sensitivity and specificity
|Issue Date: ||20-Apr-2009 |
|Publisher: ||International Union against Tuberculosis and Lung Disease|
|Citation: ||Cattamanchi, A., Davis, J. L., Worodria, W., Boon, den S., Yoo, S., Matovu, J. et al. (2009). Sensitivity and specificity of fluorescence microscopy for diagnosing pulmonary tuberculosis in a high HIV prevalence setting. International Journal of Tuberculosis and Lung Disease 13(9):1130–1136.|
|Abstract: ||Setting: Mulago Hospital, Kampala, Uganda.
Objective: To evaluate the diagnostic performance of fluorescence microscopy (FM) for diagnosing pulmonary tuberculosis (TB) in a high human immunodeficiency virus (HIV) prevalence setting.
Design: Consecutive in-patients with cough for >2 weeks submitted two sputum specimens for smear microscopy. Smears were examined by conventional light microscopy (CM) and FM. The performance of the two methods was compared using mycobacterial culture as a reference standard.
Results: A total of 426 patients (82% HIV-infected) were evaluated. FM identified 11% more smear-positive patients than CM (49% vs. 38%, P < 0.001). However, positive FM results were less likely than positive CM results to be confirmed by culture when smears were read as either ‘scanty’ (54% vs. 90%, P < 0.001) or 1+ (82% vs. 91%, P = 0.02). Compared to CM, the sensitivity of FM was higher (72% vs. 64%, P = 0.005), and the specificity lower (81% vs. 96%, P < 0.001). In receiver operating characteristic analysis, maximum area under the curve for FM was obtained at a threshold of >4 acid-fast bacilli/100 fields (sensitivity 68%, specificity 90%).
Conclusion: Although FM increases the sensitivity of sputum smear microscopy, additional data on FM specificity and on the clinical consequences associated with false-positive FM results are needed to guide implementation of this technology in high HIV prevalence settings.|
|Description: ||© 2009 The Union. Available online at http://www.theunion.org/|
|ISSN: ||1027-3719 (Print)|
|Appears in Collections:||Research Articles (Bio-Medical)|
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