title: Is bleach-sedimented smear microscopy an alternative to direct microscopy under programme conditions in India?
abstract: This cross-sectional multi-centric study compared the yield of and potential benefit for detecting smear-positive pulmonary tuberculosis (PTB) by bleach sedimentation (2% sodium-hypochlorite) versus direct microscopy under programme conditions in India. Among 3168 PTB suspects, 684 (21.6%) were detected by bleach sedimentation vs. 625 (19.7%) by direct microscopy, with a proportional overall agreement of 96% (κ = 0.88). While 594 patients were smear-positive with both methods, 31 patients detected by direct microscopy were missed and an additional 90 patients were detected by bleach sedimentation. Overall, bleach sedimentation increased the yield of smear-positive TB detection; however; it also increased the time to results.
authors.affiliation: State Tuberculosis Training and Demonstration Centre, Hyderabad, Andra Pradesh, India.
authors.forename: P H
authors.initials: PH
authors.lastname: Vishnu
authors.affiliation: World Health Organization Revised National Tuberculosis Control Programme (RNTCP) Technical Assistance Project, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Bhat
authors.affiliation: World Health Organization Revised National Tuberculosis Control Programme (RNTCP) Technical Assistance Project, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Bansal
authors.affiliation: Regional Office for South-East Asia, International Union Against Tuberculosis and Lung Disease, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Satyanarayana
authors.affiliation: World Health Organization Revised National Tuberculosis Control Programme (RNTCP) Technical Assistance Project, New Delhi, India.
authors.forename: U
authors.initials: U
authors.lastname: Alavadi
authors.affiliation: RNTCP State Tuberculosis Office, Bhopal, Madhya Pradesh, India.
authors.forename: B S
authors.initials: BS
authors.lastname: Ohri
authors.affiliation: RNTCP State Tuberculosis Office, Hyderabad, Andra Pradesh, India.
authors.forename: M S Rao
authors.initials: MS
authors.lastname: Shrinivas
authors.affiliation: Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India.
authors.forename: P
authors.initials: P
authors.lastname: Desikan
authors.affiliation: World Health Organization Revised National Tuberculosis Control Programme (RNTCP) Technical Assistance Project, New Delhi, India.
authors.forename: J
authors.initials: J
authors.lastname: Jaju
authors.affiliation: Regional Medical Research Center for Tribals, Jabalpur, Madhya Pradesh, India.
authors.forename: V G
authors.initials: VG
authors.lastname: Rao
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Moonan
keywords: TB diagnosis; bleach sedimentation; bleach smears; conventional microscopy; direct smears