3.5. Factors influencing smear microscopy3.5.1. Gender Difference Although the literature on Indian women and TB is scanty, several factors such as self-image, status in family and society, access to resources, and social stigma clearly have different effects on health-seeking behavior for TB among women and men. TB affects women mainly in their economically and reproductively active years, and the impact of the disease is also strongly felt by their children and families166.
Chapter III The gender disaggregated review of laboratory registers for the year 2002 in the eight districts of four Indian states showed that167: (i) Less number of female subjects presented themselves at the microscopy centers for sputum examination for TB diagnosis …show more content…
Two LTs independently evaluated the gross appearance and volume of sputum specimen. Gross appearance of sputum was classified into saliva, mucoid, purulent, or blood stained250. Specimen was sent to local reference laboratory, where FS by AO was done. The first two sputum (spot and morning) specimens were inoculated in Ogawa culture medium and the third sputum (morning) sample underwent both solid (Ogawa) and liquid cultures (BACTEC and MGIT). Specimens were decontaminated using 4% NaOH for solid culture and NALC?NaOH (2%) for liquid culture. Among 2,493 patients underwent TB examination, 170 were confirmed active PT. In this, 42.9% (73) were SP. While gross appearance was associated with smear positivity in both sexes [purulent or blood-tinged sputum (rather than mucoid sputum or saliva); OR, 2.05, 95% CI, 1.21?3.47 in men; OR, 2.78, 95% CI, 1.23?6.26 in women], the amount of sputum specimens was associated with smear positivity in only female patients (?4 mL versus < …show more content…
Daley et al.279 conducted a pilot study and compared NaOCl and universal sediment processing (USP) as chemical methods, both used in combination with centrifuge. After careful homogenization, duplicate smears were prepared and stained by ZN staining and AO FS techniques. Samples were processed by 5% NaOCl and USP techniques, and again, duplicate smears were prepared with deposit and stained by ZN staining and AO FS techniques. Deposit was cultured on LJ medium and BACTEC. Of 178 TB suspects, 36 (20.2%) were CP by either solid or liquid culture. Direct ZN staining detected 22 of 36 cases, and direct AO FS smears detected 26 of 36 cases. NaOCl and USP centrifugation techniques detected 24 cases each, providing no incremental yield beyond direct smears. When compared with combined culture, pretreated smears were not more sensitive than direct smears [66.6% versus 61.1% (ZN staining) or 72.2% (AO FS)] and were not more specific [(92.3% versus 93.0% (ZN staining) or 97.2% (AO FS)]. The authors mentioned that use of very small volume (0.5 mL) of sputum for smear preparation was the limitation of the
Chapter III The gender disaggregated review of laboratory registers for the year 2002 in the eight districts of four Indian states showed that167: (i) Less number of female subjects presented themselves at the microscopy centers for sputum examination for TB diagnosis …show more content…
Two LTs independently evaluated the gross appearance and volume of sputum specimen. Gross appearance of sputum was classified into saliva, mucoid, purulent, or blood stained250. Specimen was sent to local reference laboratory, where FS by AO was done. The first two sputum (spot and morning) specimens were inoculated in Ogawa culture medium and the third sputum (morning) sample underwent both solid (Ogawa) and liquid cultures (BACTEC and MGIT). Specimens were decontaminated using 4% NaOH for solid culture and NALC?NaOH (2%) for liquid culture. Among 2,493 patients underwent TB examination, 170 were confirmed active PT. In this, 42.9% (73) were SP. While gross appearance was associated with smear positivity in both sexes [purulent or blood-tinged sputum (rather than mucoid sputum or saliva); OR, 2.05, 95% CI, 1.21?3.47 in men; OR, 2.78, 95% CI, 1.23?6.26 in women], the amount of sputum specimens was associated with smear positivity in only female patients (?4 mL versus < …show more content…
Daley et al.279 conducted a pilot study and compared NaOCl and universal sediment processing (USP) as chemical methods, both used in combination with centrifuge. After careful homogenization, duplicate smears were prepared and stained by ZN staining and AO FS techniques. Samples were processed by 5% NaOCl and USP techniques, and again, duplicate smears were prepared with deposit and stained by ZN staining and AO FS techniques. Deposit was cultured on LJ medium and BACTEC. Of 178 TB suspects, 36 (20.2%) were CP by either solid or liquid culture. Direct ZN staining detected 22 of 36 cases, and direct AO FS smears detected 26 of 36 cases. NaOCl and USP centrifugation techniques detected 24 cases each, providing no incremental yield beyond direct smears. When compared with combined culture, pretreated smears were not more sensitive than direct smears [66.6% versus 61.1% (ZN staining) or 72.2% (AO FS)] and were not more specific [(92.3% versus 93.0% (ZN staining) or 97.2% (AO FS)]. The authors mentioned that use of very small volume (0.5 mL) of sputum for smear preparation was the limitation of the