Abstract
BackgroundThe comparatively straightforward and cheaper light-emitting diode fluorescent microscope (LEDFM) was suggested by WHO to replace conventional microscope in tuberculosis (TB) laboratories. However, the comparable efficacy of each of those techniques differs from laboratory to laboratory. We investigated the efficacy of LEDFM for the diagnosis of tuberculous lymphadenitis (TBLN) patients.MethodsA cross-sectional study was conducted on 211 samples from clinically suspected tuberculous lymphadenitis patients. Three smears were prepared from FNA on microscope slides for cytomorphology study, Auramine O (AO), and for Ziehl-Neelsen (ZN) staining. The left-over samples were inoculated onto Lowenstein-Jensen (LJ) media. Statistical analysis was done using STATA version 11. The sensitivity, specificity, positive and negative predictive values were calculated by considering the culture results as the gold standard using a 95% confidence interval.ResultsAmong 211 samples 49.7% (105) were positive by cytomorphology, 32.7% (69) by LEDFM, 23.69% (50) by LJ culture, and 13.7% (29) by ZN. Compared to the gold standard sensitivity of ZN, LEDFM, and cytomorphology were 30% [95% CI: 17.9–44.6], 66% [95% CI: 51.2–78.8] 78% [95% CI: 64–88.5], respectively. The specificity of ZN, LEDFM, and cytomorphology was 91.3% [95% CI: 85.8–95.2], 77.6% [95% CI: 70.4–83.8], 58.8% [95% CI: 50.7–66.5], respectively.ConclusionLED fluorescence microscopy gives a legitimate option in contrast to conventional ZN techniques in terms of its higher sensitivity, a bit lower specificity, time-saving, and minimal effort.
Highlights
The comparatively straightforward and cheaper light-emitting diode fluorescent microscope (LEDFM) was suggested by WHO to replace conventional microscope in tuberculosis (TB) laboratories
We investigated the efficacy of LEDFM for the diagnosis of tuberculous lymphadenitis (TBLN) patients
Light-Emitting Diode (LED) fluorescence microscopy gives a legitimate option in contrast to conventional ZN techniques in terms of its higher sensitivity, a bit lower specificity, time-saving, and minimal effort
Summary
A cross-sectional study was conducted on 211 samples from clinically suspected tuberculous lymphadenitis patients. ; counterstained with 0.5% potassium permanganate for 2–4 minutes, rinsed with sterile water and allowed to air dry and smears were examined under the LED fluorescence microscope (Primo Star iLED, Carl Zeiss, Gottingen, Germany) at 400X magnification (455nm) [20]. Carbol fuchsin stain was applied to cover the entire slide and slowly heated using a Bunsen burner until steam arose and kept for 5 minutes After this procedure, the slides were rinsed with distilled water and flooded with 3% acid alcohol, and allowed to decolorize for 3 minutes. The washed and dried smears were examined under the bright field microscope (Primo Star iLED, Carl Zeiss, Gottingen, Germany) at 1000X magnification and interpreted as indicated Table 2 in S1 File [21]
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