Evaluation of LED Fluorescence Microscopy for The Diagnosis of Pulmonary Tuberculosis in Cuba
Keywords:
LED fluorescence microscopy, tuberculosis, bacilloscopy.Abstract
Introduction: Light-emitting diode fluorescence microscopy (LED FM) has been recommended by the World Health Organization to diagnose tuberculosis since 2011.
Objective: To evaluate the performance of LED FM for the diagnosis of pulmonary tuberculosis at the National Reference Laboratory for Tuberculosis, Leprosy, and Mycobacteria (NRL-TBLM) in Cuba.
Methods: LED FM evaluation was conducted on sputum samples from patients with suspected tuberculosis at the NRL-TBLM from February to July 2018. Due to the low prevalence of tuberculosis in Cuba, it was followed the methodology used by Minion and others.
Results: LED FM identified 28/208 (13.5%) bacilli in smears from patients with suspected tuberculosis, 10 more than Zielh Neelsen staining (18/208). Five of the positive cases identified by fluorescent microscopy were people living with HIV/AIDS, and a higher number of paucibacillary smears (six) were identified, four of which were from people living with HIV/AIDS. Sensitivity (81.82%) and Youden index (0.81) were higher than those obtained by Zielh Neelsen staining (54.55% and 0.55%, respectively). The calculated area under the curve was higher for LED FM (0.8966).
Conclusions: This study confirms that LED FM has higher sensitivity. Its inclusion in the tuberculosis diagnostic algorithm will increase the detection of cases of smear-positive pulmonary tuberculosis. Its implementation in selected laboratories within the network will contribute to progress towards the elimination of the disease within the framework of the Global Tuberculosis Elimination Strategy by 2035.
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