Adequacy of two versus three sputum specimens for the diagnosis of pulmonary tuberculosis.
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Date
2009-11
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Abstract
Background. The new guidelines issued by the Revised
National Tuberculosis Control Programme for diagnosis of
smear-positive tuberculosis recommend examination of only 2
sputum smears. We did a retrospective analysis of data from
a designated microscopy centre to ascertain the diagnostic
yield of 2 smears and the additional yield provided by the third
smear.
Methods. Data were obtained from the designated microscopy
centre attached to our medical college. A total of 3257
patients with suspected tuberculosis had undergone sputum
examination between September 2004 and March 2009.
However, only 1762 of them had 3 sputum specimens examined.
Data were entered and analysed using SPSS version 11.5.
Results. Among the 1762 suspected patients, positivity in
any 2 samples was found to be 17.7% while 19% were found
to be positive in a single smear. A statistically insignificant
association was found between the grading and positivity of the
sputum samples using McNemar test. A positive third sample
was found in 309 patients. If the first 2 samples were negative,
the possibility of missing a third positive sample was 0.4%.
Conclusion. Under field conditions, 2 sputum smears are as effective as 3 smears for diagnosing smear-positive tuberculosis.
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Kumar Ashwini, Bairy Indira, Rao Chythra R, Prasad Vishnu, Pattanshetty Sanjay, Samarasinghe Charmaine Minoli. Adequacy of two versus three sputum specimens for the diagnosis of pulmonary tuberculosis. National Medical Journal of India. 2009 Nov-Dec; 22(6): 298-299.