title: Same-day light-emitting diode fluorescence microscopy for the diagnosis of tuberculosis in Chhattisgarh, India.
abstract: METHODS
  Three medical college hospitals using light-emitting diode fluorescence microscopy (LED-FM) for diagnosing tuberculosis (TB) in Chhattisgarh, India.
  
  
  OBJECTIVE
  To assess and compare the proportion of sputum smear-positive TB patients diagnosed through same-day microscopy (spot-spot) strategy or with the conventional (spot-morning) strategy.
  
  
  METHODS
  During November 2012 - March 2013, all consecutively enrolled presumptive TB patients (aged ≥ 18 years) were requested to provide three specimens: two spot specimens collected 1 h apart on the first day and one early morning specimen the next day; these were stained using auramine-O and examined using LED-FM.
  
  
  RESULTS
  Of 1716 (93% of total 1845) presumptive TB patients who provided all three specimens, 218 (13%) were smear-positive: 200 (11.7%) by same-day microscopy and 217 (12.7%) by the conventional method (McNemar's χ(2) 13.5, df 1, P = 0.0002). Eighteen (8.3%) cases were missed by the same-day method.
  
  
  CONCLUSIONS
  Although LED-FM is more sensitive to paucibacillary samples, 8% of smear-positive cases were missed using the same-day method. These findings indicate the need to revisit the global applicability of the current World Health Organization recommendation of switching to same-day diagnosis from the conventional policy.
authors.affiliation: World Health Organization Country Office for India, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Nayak
authors.affiliation: International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India.
authors.forename: A M V
authors.initials: AM
authors.lastname: Kumar
authors.affiliation: State Tuberculosis Office, Directorate of Health Services, Raipur, Chhattisgarh, India.
authors.forename: T K
authors.initials: TK
authors.lastname: Agrawal
authors.affiliation: Intermediate Reference Laboratory, Raipur, Chhattisgarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Chandraker
authors.affiliation: World Health Organization Country Office for India, New Delhi, India.
authors.forename: S A
authors.initials: SA
authors.lastname: Nair
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005188:False Negative Reactions; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult