Comparative cost and performance of light-emitting diode microscopy in HIV-tuberculosis-co-infected patients
Comparative cost and performance of light-emitting diode microscopy in HIV-tuberculosis-co-infected patients
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DOI：
10.1183/09031936.00023211
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发表时间：
2011-12-01
影响因子：
24.3
通讯作者：
Dheda, K.
中科院分区：
文献类型：
--
作者：
Whitelaw, A.;Peter, J.;Dheda, K.
Light-emitting diode (LED) microscopy has recently been endorsed by the World Health Organization (WHO). However, it is unclear whether LED is as accurate and cost-effective as Ziehl-Neelsen (ZN) microscopy or mercury vapour fluorescence microscopy (MVFM) in tuberculosis (TB)-HIV-co-infected subjects.Direct and concentrated sputum smears from TB suspects were evaluated using combinations of LED microscopy, ZN microscopy and MVFM. Median reading time per slide was recorded and a cost analysis performed. Mycobacterial culture served as the reference standard.647 sputum samples were obtained from 354 patients (88 (29.8%) were HIV-infected and 161 (26%) were culture-positive for Mycobacterium tuberculosis). Although overall sensitivity of LED compared with ZN microscopy or MVFM was similar, sensitivity of all three modalities was lower in HIV-infected patients. In the HIV-infected group, the sensitivity of LED microscopy was higher than ZN microscopy using samples that were not concentrated (46 versus 39%; p=0.25), and better than MVFM using concentrated samples (56 versus 44; p=0.5). A similar trend was seen in the CD4 count
