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EVALUATION OF SODIUM HYPOCHLORITE SEDIMENTATION MICROSCOPY METHOD FOR THE LABORATORY DIAGNOSIS OF PULMONARY TUBERCULOSIS 

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Resource details

Resource ID

238

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Contributed by

Rajan Karmacharya

Author/Contributor

Sanjay Gyawali

Publisher/Credit

St. Xavier's College

Date

16 November 16

Document type

Thesis or project

Department

Microbiology

Level

Master

Batch

2008

Abstract

Microscopy is the primary tool for the diagnosis of tuberculosis mostly in developing
countries where resources are limited, but direct smear microscopy have low sensitivity. If
sensitivity of this method can be increased by some modification it will surely help to fight
against tuberculosis in resources poor countries. This study evaluates sodium hypochlorite
(NaOCl) gravity sediment smear microscopy method of the sputum sample for diagnosis of
pulmonary tuberculosis (PTB) by Ziehl Neelsen (ZN) and fluorescence staining technique.
The study was hospital based study conducted at National Tuberculosis Centre (NTC),
Thimi, Bhaktapur from April to September 2010. From the valid 160 sputum samples of
the PTB suspected patients visiting NTC, the direct and overnight sediment smears were
prepared for ZN and fluorescence staining. The staining methods were evaluated on the
basis of sensitivity and specificity obtained in each technique with reference to sputum
culture employed as gold standard. Out of total 160 sample cultured, 31 were culture
positive, 129 were culture negative. The false negative results produced by ZN and
fluorescence stain were 51.2% & 45.17% from direct smear whereas 25.81% & 19.61%
from NaOCl sediment smear respectively. False positive result obtained by ZN and
fluorescence stain by direct smear were 0% and 0.78% respectively where as false positive
results by ZN and fluorescence with NaOCl sediment were 1.56% and 2.36% respectively.
The sensitivity of direct ZN staining method and direct fluorescence staining method was
48.38% and 54.83% respectively. Specificity of direct microscopy was 100% and 99.2%
for ZN and fluorescence method respectively. The sensitivity and specificity of NaOCl
sediment smear ZN staining method was 74.19% and 98.44% respectively. The sensitivity
and specificity of NaOCl sediment fluorescence staining method was found to be 80.64%
and 97.67% respectively. Statistically significant differences was observed between
different staining techniques and culture (P<0.05). The present study indicates that
fluorescence staining with NaOCl overnight sediment smear is more sensitive than other
methods therefore it can be used effectively for tuberculosis diagnosis.

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