title: Evaluation of mobile digital light-emitting diode fluorescence microscopy in Hanoi, Viet Nam.
abstract: METHODS
  Hanoi Lung Hospital, Hanoi, Viet Nam.
  
  
  OBJECTIVE
  To compare the accuracy of CellScopeTB, a manually operated mobile digital fluorescence microscope, with conventional microscopy techniques.
  
  
  METHODS
  Patients referred for sputum smear microscopy to the Hanoi Lung Hospital from May to September 2013 were included. Ziehl-Neelsen (ZN) smear microscopy, conventional light-emitting diode (LED) fluorescence microscopy (FM), CellScopeTB-based LED FM and Xpert(®) MTB/RIF were performed on sputum samples. The sensitivity and specificity of microscopy techniques were determined in reference to Xpert results, and differences were compared using McNemar's paired test of proportions.
  
  
  RESULTS
  Of 326 patients enrolled, 93 (28.5%) were Xpert-positive for TB. The sensitivity of ZN microscopy, conventional LED FM, and CellScopeTB-based LED FM was respectively 37.6% (95%CI 27.8-48.3), 41.9% (95%CI 31.8-52.6), and 35.5% (95%CI 25.8-46.1). The sensitivity of CellScopeTB was similar to that of conventional LED FM (difference -6.5%, 95%CI -18.2 to 5.3, P = 0.33) and ZN microscopy (difference -2.2%, 95%CI -9.2 to 4.9, P = 0.73). The specificity was >99% for all three techniques.
  
  
  CONCLUSIONS
  CellScopeTB performed similarly to conventional microscopy techniques in the hands of experienced TB microscopists. However, the sensitivity of all sputum microscopy techniques was low. Options enabled by digital microscopy, such as automated imaging with real-time computerized analysis, should be explored to increase sensitivity.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Chaisson
authors.affiliation: Bioengineering Department, University of California Berkeley, Berkeley, USA.
authors.forename: C
authors.initials: C
authors.lastname: Reber
authors.affiliation: Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, USA.
authors.forename: H
authors.initials: H
authors.lastname: Phan
authors.affiliation: Bioengineering Department, University of California Berkeley, Berkeley, USA; Biophysics Graduate Group, University of California Berkeley, Berkeley, California, USA.
authors.forename: N
authors.initials: N
authors.lastname: Switz
authors.affiliation: Bioengineering Department, University of California Berkeley, Berkeley, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Nilsson
authors.affiliation: Bioengineering Department, University of California Berkeley, Berkeley, USA.
authors.forename: F
authors.initials: F
authors.lastname: Myers
authors.affiliation: National Lung Hospital, Ba Dinh, Hanoi.
authors.forename: N V
authors.initials: NV
authors.lastname: Nhung
authors.affiliation: Hanoi Health Services Department, Ba Dinh, Hanoi.
authors.forename: L
authors.initials: L
authors.lastname: Luu
authors.affiliation: Hanoi Lung Hospital, Hai Ba Trung, Hanoi, Viet Nam.
authors.forename: T
authors.initials: T
authors.lastname: Pham
authors.affiliation: Hanoi Lung Hospital, Hai Ba Trung, Hanoi, Viet Nam.
authors.forename: C
authors.initials: C
authors.lastname: Vu
authors.affiliation: Hanoi Lung Hospital, Hai Ba Trung, Hanoi, Viet Nam.
authors.forename: H
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: Hanoi Lung Hospital, Hai Ba Trung, Hanoi, Viet Nam.
authors.forename: A
authors.initials: A
authors.lastname: Nguyen
authors.affiliation: Hanoi Lung Hospital, Hai Ba Trung, Hanoi, Viet Nam.
authors.forename: T
authors.initials: T
authors.lastname: Dinh
authors.affiliation: Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, USA; Curry International Tuberculosis Center, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA.
authors.forename: P
authors.initials: P
authors.lastname: Nahid
authors.affiliation: Biophysics Graduate Group, University of California Berkeley, Berkeley, California, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Fletcher
authors.affiliation: Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, USA; Curry International Tuberculosis Center, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA.
authors.forename: A
authors.initials: A
authors.lastname: Cattamanchi
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008856:Microscopy, Fluorescence / Q000295:instrumentation*; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*; D014744:Vietnam