Bacilloscopy for pulmonary tuberculosis. Multicenter study of bacilloscopy sputum smears in the diagnosis of pulmonary tuberculosis according to the World Health Organization and Brazilian Ministry of Health

Authors

  • Heloisa da Silveira Paro Pedro
  • Susilene Maria Tonelli Nardi
  • Maria Izabel Pereira Ferreira
  • Maria do Rosário Assad Goloni
  • Regina Ruivo Ferro e Silva
  • Dalva Cristina Girello Aily
  • Andréa Gobetti Vieira Coelho
  • Andréa R. Leite
  • Leonilda Chiari Galle
  • Maria de Lourdes M. Shikama
  • Cacilda Rosa Cardoso da Silva
  • Suely Yoko Mizuka Yoko Mizuka Ueki

DOI:

https://doi.org/10.5216/rpt.v39i4.13062

Keywords:

Diagnosis, Tuberculosis, Health Services, World Health Organization.

Abstract

In the diagnosis of pulmonary tuberculosis, sputum bacilloscopy was standardized
by the WHO for slide preparation, staining, and reading the smear. The Brazilian
Ministry of Health adopted this standardization for staining and reading, but
the smear was extended to 2/3 of the slide, different to the elliptical format
recommended by the WHO. This study aimed at comparing the two smear
techniques by evaluating the sensitivity and specificity, preparation and reading
times, and biosafety issues. Eight regional laboratories of the Adolfo Lutz Institute
participated. Over three months, slides were prepared for 356 sputum samples
using the two techniques. Reading of slides employed semi-quantitative counts
using bacilloscopy index scale as recommended by the WHO and Brazilian
Ministry of Health. The sensitivity of the elliptical smear was 97.0%, specificity
97.5%, accuracy 97.2%, and error 2.8%. Agreement of classification according
to the scale was: 80.7% for rare BAAR, 83.7% for 1+, 89.8% for 2+, 90.9% for
3+ and 97.5% for negative cases (Kappa=0.87 p<0.001). Preparing (p=0.03) and
reading (p=0.01) the smear were faster by the WHO method and better in relation
to biosafety. This study demonstrated the viability of adopting the smear technique
standardized throughout the world by the WHO.

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Published

2011-01-31

How to Cite

PEDRO, H. da S. P.; NARDI, S. M. T.; FERREIRA, M. I. P.; GOLONI, M. do R. A.; SILVA, R. R. F. e; AILY, D. C. G.; COELHO, A. G. V.; LEITE, A. R.; GALLE, L. C.; SHIKAMA, M. de L. M.; SILVA, C. R. C. da; UEKI, S. Y. M. Y. M. Bacilloscopy for pulmonary tuberculosis. Multicenter study of bacilloscopy sputum smears in the diagnosis of pulmonary tuberculosis according to the World Health Organization and Brazilian Ministry of Health. Revista de Patologia Tropical / Journal of Tropical Pathology, Goiânia, v. 39, n. 4, p. 273–282, 2011. DOI: 10.5216/rpt.v39i4.13062. Disponível em: https://revistas.ufg.br/iptsp/article/view/13062. Acesso em: 23 nov. 2024.

Issue

Vol. 39 No. 4 (2010)

Section

ORIGINAL ARTICLES

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