{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T12:10:14Z","timestamp":1747224614276,"version":"3.40.5"},"reference-count":26,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T00:00:00Z","timestamp":1601251200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Afr. J. Lab. Med."],"abstract":"<jats:p>Background: Despite its low sensitivity, microscopy remains the main method for the diagnosis of pulmonary tuberculosis in most laboratories in Ethiopia. Few studies have evaluated the performance of light-emitting diode fluorescent microscopy (LED-FM) in bleach-concentrated smear-negative sputum specimens.Objective: This study aimed to evaluate the diagnostic performance of LED-FM for smear-negative pulmonary tuberculosis in Ethiopia.Methods: A total of 194 adult patients with a cough lasting for more than two weeks, and who had three direct smear-negative sputum tests for Mycobacterium tuberculosis by Ziehl-Neelsen light microscopy, were included. All direct Ziehl-Neelsen-stained smear-negative sputum samples were cultured and were also visualised by LED-FM. Smears for LED-FM were performed from bleach-concentrated sputum sediment. The diagnostic performance of the LED-FM was compared to the culture method (the reference standard).Results: Of the 194 smear-negative sputum specimens analysed, 28 (14.4%) were culture-positive and 21 (10.8%) were LED-FM-positive for M. tuberculosis. However, only 11 of the 21 (52.4%) LED-FM-positive patients had a confirmed tuberculosis diagnosis by culture. Light-emitting diode fluorescence microscopy (FM) had a sensitivity of 39.3% (95% confidence interval: 21.2\u201357.4) and specificity of 93.9% (95% confidence interval: 90.4\u201397.6). Ten LED-FM-positive specimens were culture-negative, and all of these specimens had scanty grading (1\u201319 bacilli per 40 fields on LED-FM).Conclusion: This study showed that implementation of LED-FM on bleach pre-treated and concentrated sputum can significantly improve the diagnosis of smear-negative pulmonary tuberculosis. However, all scanty grade, positive smears by LED-FM need to be confirmed by reference culture method.<\/jats:p>","DOI":"10.4102\/ajlm.v9i1.810","type":"journal-article","created":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T14:41:11Z","timestamp":1601131271000},"source":"Crossref","is-referenced-by-count":1,"title":["Fluorescence microscopy for the diagnosis of smear-negative pulmonary tuberculosis in Ethiopia"],"prefix":"10.4102","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7172-9136","authenticated-orcid":false,"given":"Gemeda","family":"Abebe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9688-0297","authenticated-orcid":false,"given":"Dossegnaw","family":"Aragaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4751-2225","authenticated-orcid":false,"given":"Mulualem","family":"Tadesse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2580","published-online":{"date-parts":[[2020,9,28]]},"reference":[{"year":"2016","author":"World Health Organization","key":"ref0001"},{"key":"ref0002","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.13.0417"},{"key":"ref0003","doi-asserted-by":"publisher","DOI":"10.1086\/591974"},{"key":"ref0004","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)03406-0"},{"issue":"9","key":"ref0005","first-page":"847","volume":"5","author":"Hargreaves","year":"2001","journal-title":"Int J Tuberc Lung Dis"},{"journal-title":"Xpert MTB\/RIF implementation manual: Technical and operational \u2018how-to\u2019; practical considerations","year":"2014","author":"World Health Organization","key":"ref0006"},{"journal-title":"Implementation guideline for GeneXpert MTB\/RIF assay in Ethiopia","year":"2014","author":"Federal Democratic Republic of Ethiopia Ministry of Health\/Ethiopian Public Health Institute","key":"ref0007"},{"journal-title":"AFB smear microscopy manual","year":"2014","author":"Federal Minister of Health","key":"ref0008"},{"key":"ref0009","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60284-0"},{"journal-title":"Improving the diagnosis and treatment of smear-negative pulmonary and extrapulmonary tuberculosis among adults and adolescents: Recommendations for HIV-prevalent and resource-constrained settings","year":"2007","author":"World Health Organization","key":"ref0010"},{"journal-title":"Treatment of tuberculosis: Guidelines","year":"2010","author":"World Health Organization","key":"ref0011"},{"key":"ref0012","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(06)70578-3"},{"key":"ref0013","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0015206"},{"key":"ref0014","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004093"},{"journal-title":"Report of the 9th meeting of STAG-TB","year":"2009","author":"World Health Organization","key":"ref0015"},{"key":"ref0016","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmyco.2015.01.002"},{"journal-title":"Treatment of tuberculosis: Guidelines for national programmes","year":"1993","author":"World Health Organization","key":"ref0017"},{"journal-title":"Medical microbiology-diagnosis of tuberculosis. 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