{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:16:24Z","timestamp":1791155784481,"version":"4.1.0"},"reference-count":13,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2004,3,1]],"date-time":"2004-03-01T00:00:00Z","timestamp":1078099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2004,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Direct smear examination with Ziehl-Neelsen (ZN) staining for the diagnosis of tuberculosis (TB) as employed in most low-income countries is cheap and easy to use, but its low sensitivity is a major drawback. The low specificity of chest X-rays, used for the diagnosis of smear-negative TB, risks high levels of overdiagnosis. Major advances in molecular techniques, which rapidly identify mycobacterial DNA in sputa, may overcome these obstacles. In this study, the AMPLICOR PCR system was used to diagnose pulmonary TB in a developing country with high prevalences of both TB and human immunodeficiency virus (HIV). The sensitivity and specificity of this technique were compared to those of the usual diagnostic techniques. Sputum specimens were collected from 1,396 TB suspects attending the Rhodes Chest Clinic, Nairobi, Kenya. The specimens were analyzed for the presence of\n            <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n            by PCR; culture on Lo\u0308wenstein-Jensen medium was used as the \u201cgold standard.\u201d All culture-positive samples were genotyped to identify the mycobacterial species. The sensitivity and specificity of PCR were 93 and 84%, respectively. HIV status did not affect the sensitivity of PCR. A total of 99.7% of the true smear-positive and 82.1% of the true smear-negative TB patients were correctly identified by PCR. PCR detected\n            <jats:italic>M. tuberculosis<\/jats:italic>\n            in 11.7% of the culture-negative suspects, 60% of which had one or two PCR-positive sputum specimens. Of the 490 positive cultures, 486 were identified as\n            <jats:italic>M. tuberculosis<\/jats:italic>\n            . The high sensitivity of Amplicor PCR merits usage in a clinical setting with high TB and HIV burdens. Thus, PCR can be considered as an alternative to ZN staining in combination with chest X-ray for diagnosis of TB; however, cost-effectiveness studies and operational studies are required to support an evidence-based decision of introducing PCR for TB control in high-burden environments.\n          <\/jats:p>","DOI":"10.1128\/jcm.42.3.1012-1015.2004","type":"journal-article","created":{"date-parts":[[2004,3,5]],"date-time":"2004-03-05T23:57:55Z","timestamp":1078531075000},"page":"1012-1015","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":75,"title":["Comparison of PCR with the Routine Procedure for Diagnosis of Tuberculosis in a Population with High Prevalences of Tuberculosis and Human Immunodeficiency Virus"],"prefix":"10.1128","volume":"42","author":[{"given":"Lydia","family":"Kivihya-Ndugga","sequence":"first","affiliation":[{"name":"Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"van Cleeff","sequence":"additional","affiliation":[{"name":"Departments of Health and Biomedical Research, KIT (Koninklijk Instituut voor de Tropen\/Royal Tropical Institute), Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Juma","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kimwomi","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willie","family":"Githui","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Oskam","sequence":"additional","affiliation":[{"name":"Departments of Health and Biomedical Research, KIT (Koninklijk Instituut voor de Tropen\/Royal Tropical Institute), Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Schuitema","sequence":"additional","affiliation":[{"name":"Departments of Health and Biomedical Research, KIT (Koninklijk Instituut voor de Tropen\/Royal Tropical Institute), Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"van Soolingen","sequence":"additional","affiliation":[{"name":"National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Nganga","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI)"},{"name":"Centre for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kibuga","sequence":"additional","affiliation":[{"name":"National Leprosy and Tuberculosis Programme (NLTP) of The Ministry of Health, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Odhiambo","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI)"},{"name":"Centre for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Klatser","sequence":"additional","affiliation":[{"name":"Departments of Health and Biomedical Research, KIT (Koninklijk Instituut voor de Tropen\/Royal Tropical Institute), Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"247","volume":"62","year":"1996","unstructured":"B\u00f6ttger, E. C. 1996. Approaches for identification of microorganisms. ASM News62:247-250.","journal-title":"ASM News"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng1002-229"},{"key":"e_1_3_2_4_2","first-page":"364","volume":"5","year":"2001","unstructured":"Kambashi, B., G. Mbulo, R. McNerney, R. Tembwe, A. Kambashi, V. Tihon, and P. Godfrey-Faussett. 2001. Utility of nucleic acid amplification techniques for the diagnosis of pulmonary tuberculosis in sub-Saharan Africa. Int. J. Tuberc. Lung Dis.5:364-369.","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/47.8.1553"},{"key":"e_1_3_2_6_2","unstructured":"Kent P. T. and G. P. Kubica. 1985. Public health laboratory. A guide for the level III laboratory. U.S. Department of Health and Human Services publication no. (CDC) 86-8230. Centers for Disease Control and Prevention Atlanta Ga."},{"key":"e_1_3_2_7_2","unstructured":"Ministry of Health of Kenya. 2000. Guidelines for tuberculosis and leprosy control for health workers in Kenya. Ministry of Health Nairobi Kenya."},{"key":"e_1_3_2_8_2","first-page":"S182","volume":"4","year":"2000","unstructured":"Perkins, M. D. 2000. New diagnostic tools for tuberculosis. Int. J. Tuberc. Lung Dis.4:S182-S188.","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"e_1_3_2_9_2","first-page":"235","volume":"2","year":"1998","unstructured":"Roos, B. R., M. R. A. van Cleeff, W. A. Githui, L. Kivihya-Ndugga, D. K. Kibuga, and P. R. Klatser. 1998. Cost-effectiveness of the polymerase chain reaction versus smear-examination for the diagnosis of tuberculosis in Kenya: a theoretical model. Int. J. Tuberc. Lung Dis.2:235-241.","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.7.3233-3240.2003"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/47.5.809"},{"key":"e_1_3_2_12_2","first-page":"186","volume":"7","year":"2003","unstructured":"Van Cleeff, M. R. A., L. Kivihya-Ndugga, W. A. Githui, L. Nganga, J. A. Odhiambo, and P. R. Klatser. 2003. A comprehensive study on the efficiency of the routine tuberculosis diagnostic process in Nairobi. Int. J. Tuberc. Lung Dis.7:186-189.","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.5858\/2001-125-0122-MTIMD"},{"key":"e_1_3_2_14_2","unstructured":"World Health Organization. 2002. Global tuberculosis control. WHO report 2002. WHO\/CDS\/TB\/2002.295. World Health Organization Geneva Switzerland."}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.42.3.1012-1015.2004","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.42.3.1012-1015.2004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T03:04:36Z","timestamp":1646449476000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/JCM.42.3.1012-1015.2004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,3]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2004,3]]}},"alternative-id":["10.1128\/JCM.42.3.1012-1015.2004"],"URL":"https:\/\/doi.org\/10.1128\/jcm.42.3.1012-1015.2004","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,3]]},"assertion":[{"value":"2003-09-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2003-11-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2004-03-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}