title: Tuberculosis diagnosis after bleach processing for early stage tuberculosis laboratory capacity building.
abstract: The diagnosis of tuberculosis is seriously hampered in the absence of standard biosafety laboratory facilities for specimen concentration and Mycobacterium tuberculosis culture. Within a laboratory twinning arrangement, heat-fixed direct smear and sediment from 74 bleach-processed  and 20 non-processed specimens from Cumura Hospital, Guinea-Bissau, were sent to Lisbon for molecular evaluation of rifampicin resistance. Sequence analysis of a 369 base-pair rpoB locus detected 3.2% (3/94) resistant specimens. To our knowledge, this represents the first report on  the molecular analysis of M. tuberculosis from bleach-processed sputum, an alternative to current diagnostic practice in low-resource settings.
authors.affiliation: Instituto Nacional de Saúde Dr. Ricardo Jorge, INSA, IP, Lisbon, Portugal. david.suzana@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: David
authors.forename: A F
authors.initials: AF
authors.lastname: Sutre
authors.forename: A
authors.initials: A
authors.lastname: Sanca
authors.forename: A
authors.initials: A
authors.lastname: Mané
authors.forename: V
authors.initials: V
authors.lastname: Henriques
authors.forename: C
authors.initials: C
authors.lastname: Portugal
authors.forename: L
authors.initials: L
authors.lastname: Sancho
authors.forename: A
authors.initials: A
authors.lastname: Cardoso
authors.forename: E
authors.initials: E
authors.lastname: Paixão
authors.forename: E L
authors.initials: EL
authors.lastname: Duarte
authors.forename: C Q F
authors.initials: CQ
authors.lastname: Leite
authors.forename: J I
authors.initials: JI
authors.lastname: Salem
authors.forename: A
authors.initials: A
authors.lastname: Antunes
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D001483:Base Sequence; D057191:Capacity Building / Q000379:methods*; D019411:Clinical Laboratory Techniques; D012321:DNA-Directed RNA Polymerases; D006169:Guinea-Bissau; D006801:Humans; D007753:Laboratories / Q000458:organization & administration; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D011174:Portugal; D012293:Rifampin / Q000494:pharmacology; D017421:Sequence Analysis; D012973:Sodium Hypochlorite / Q000737:chemistry*; D013048:Specimen Handling / Q000379:methods*; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins; C505805:rpoB protein, Mycobacterium tuberculosis; D012973:Sodium Hypochlorite; D012321:DNA-Directed RNA Polymerases; D012293:Rifampin