{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:44:25Z","timestamp":1791575065059,"version":"4.3.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Cerba Xpert"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To assess the diagnostic accuracy of sputum smear microscopy compared with culture in patients who were already confirmed positive for tuberculosis by Xpert\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      \/rifampicin assay in Tanzania.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study was conducted across five tuberculosis clinics in Dar es Salaam. Adults (aged 18\u201380 years) with symptoms of tuberculosis and a positive Xpert\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      \/rifampicin assay result provided additional sputum specimens for smear microscopy using Ziehl\u2013Neelsen staining and culture on L\u00f6wenstein\u2013Jensen medium, processed at the Central Tuberculosis Reference Laboratory, Muhimbili National Hospital.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We enrolled 200 participants, with a median age of 35 (interquartile range: 27\u201346) years; 74.5% of them were male. Using culture as the reference, Ziehl\u2013Neelsen smear microscopy showed a sensitivity of 86.6% and a specificity of 40.7%. The Xpert\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      \/rifampicin assay showed higher diagnostic accuracy. Notably, 43% of smear-negative cases were culture-positive, indicating that smear microscopy alone led to a substantial proportion of missed diagnoses. The Ziehl\u2013Neelsen smear\u2019s receiver operating characteristic curve had an area under the curve of 0.64, indicating moderate performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study underscores the limitations of smear microscopy and highlights the operational utility of Xpert\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      \/rifampicin assay. In regions where Xpert Ultra remains inaccessible, combining Xpert with culture selectively may enhance detection in low-resource settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605251390703","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T03:50:42Z","timestamp":1761882642000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic accuracy of sputum smear microscopy compared with culture in patients with tuberculosis confirmed by Xpert\n                    <i>Mycobacterium tuberculosis<\/i>\n                    \/rifampicin assay in Tanzania: A cross-sectional study"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3367-0564","authenticated-orcid":false,"given":"Sabina","family":"Mugusi","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology, School of Biomedical Sciences, Muhimbili University of Health and Allied Sciences (MUHAS), Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Lema","sequence":"additional","affiliation":[{"name":"National Institute of Medical Research (NIMR), Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ponsian","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, School of Biomedical Sciences, Muhimbili University of Health and Allied Sciences (MUHAS), Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Kamori","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, School of Diagnostic Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Happiness","family":"Kimambo","sequence":"additional","affiliation":[{"name":"Damax Solutions, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Masanja","sequence":"additional","affiliation":[{"name":"Damax Solutions, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avitus","family":"Anthony","sequence":"additional","affiliation":[{"name":"Damax Solutions, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwemezi","family":"Ngemera","sequence":"additional","affiliation":[{"name":"Damax Solutions, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos","family":"Kahwa","sequence":"additional","affiliation":[{"name":"National Institute of Medical Research (NIMR), Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"e_1_3_8_2_2","unstructured":"World Health Organization. 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