Srikanth Padma, Kamesh S, Daley Peter
Department of Microbiology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra University, Porur, Chennai, India.
Indian J Tuberc. 2009 Oct;56(4):174-84.
The Revised National Tuberculosis Control Programme (RNTCP) aims to improve case detection rates of tuberculosis to facilitate prompt recognition and treatment. The low case detection rates in the programme can be directly attributed to failure to screen patients with suspected tuberculosis and the low sensitivity of the direct smear microscopy method to detect cases among the fraction of patients that are screened. Apart from low sensitivity, this method also has other disadvantages including the increased risk of infection transmission to technicians. There are several methods that can be used to improve sensitivity, but their applicability in a national programme and in resource limited settings are limited. Bleach processing of sputum smears prior to microscopy may be a cheap and effective way to improve on the sensitivity of the direct smear. Four distinctive techniques of sputum smear processing using bleach are described in the review, with the variations in each technique, along with the sensitivity. An analysis of reports published earlier on the bleach method is also presented including a discussion on when and why the bleach method works.
修订后的国家结核病控制规划（RNTCP）旨在提高结核病病例发现率，以便及时识别和治疗。该规划中病例发现率低可直接归因于未对疑似结核病患者进行筛查，以及直接涂片显微镜检查方法在已筛查患者中检测病例的灵敏度低。除了灵敏度低之外，这种方法还有其他缺点，包括感染传播给技术人员的风险增加。有几种方法可用于提高灵敏度，但它们在国家规划和资源有限环境中的适用性有限。在显微镜检查之前对痰涂片进行漂白处理可能是提高直接涂片灵敏度的一种廉价而有效的方法。该综述描述了使用漂白剂进行痰涂片处理的四种独特技术，以及每种技术的差异和灵敏度。还对早期发表的关于漂白剂方法的报告进行了分析，包括对漂白剂方法何时起作用以及为何起作用的讨论。
