ABSTRACT
SETTING: Mawenzi Regional Hospital, northern Tanzania. OBJECTIVE: To determine the value of light-emitting diode (LED) microscopy in diagnosing tuberculosis (TB) on bleach-treated and direct sputum smears. DESIGN: Sputum samples were collected from patients suspected of pulmonary TB who presented consecutively at the laboratory for smear evaluation between December 2009 and February 2010. Four smears were prepared from each specimen: conventional Ziehl-Neelsen (ZN), direct auramine, bleach centrifugation and bleach short sedimentation auramine smears. A light microscope was used to examine ZN smears and an LED fluorescent microscope to examine auramine-stained smears. RESULTS: Of the 267 sputum samples examined, respectively 78 (29%), 62 (23%), 74 (28%) and 48 (18%) were acid-fast bacilli (AFB) positive by the bleach centrifugation, bleach short sedimentation, direct auramine and ZN methods. Bleach centrifugation identified 30 (11%) more positives than ZN microscopy (P < 0.001), but was not superior to the direct auramine method (P = 0.46), which yielded 26 (10%) more positives than ZN microscopy (P < 0.001). Fluorescent LED required a shorter smear reading time (1.5 min on average), while the light microscope took 4 min (P < 0.001). CONCLUSION: Fluorescent LED microscopy with direct smear preparation is rapid and effective. Further studies are needed to ascertain its performance under routine conditions.
Subject(s)
Microscopy, Fluorescence/methods , Mycobacterium tuberculosis/isolation & purification , Sputum/microbiology , Tuberculosis/diagnosis , Bacteriological Techniques/methods , Benzophenoneidum/chemistry , Centrifugation/methods , Humans , Sodium Hypochlorite/chemistry , Staining and Labeling/methods , Tanzania , Time Factors , Tuberculosis/microbiologyABSTRACT
Sexually transmitted diseases are thought to be important in facilitating transmission of HIV in sub-Saharan Africa. This study reports the prevalence of several sexually transmitted diseases in 106 prostitutes in Arusha and Moshi Northern Tanzania. The seroprevalence of HIV was 73% compared with 3% for local blood donors. Over half (51%) of the subjects had evidence of N. gonorrhoeae infection. Seventy-four per cent had a positive TPHA and 27% a positive RPR. Of 47 subjects tested 12 (25%) had Chlamydia trachomatis antigen detected in endocervical swabs. No significant statistical association was found between the presence of any of the STDs investigated and HIV seropositivity.
PIP: In the early 1990s, health workers spoke with, examined, and took blood samples from 106 low income 17-70 year old prostitutes mainly from the Haya tribe in their homes in the towns of Moshi in Kilimanjaro Region and Arusha in Arusha Region in Northern Tanzania (45 from Moshi and 61 from Arusha) to determine the prevalence of sexually transmitted diseases (STDs) and HIV. Number of sexual contacts/day ranged from 10-20. 40% did not use condoms at all even though they regularly received condoms as part of a health education campaign. 73% tested positive for HIV which is considerably higher than the seroprevalence in the general population in 1989 (.1-3%). Only 20% thought that they presently had an STD when actually 22-82% had at least 1 STD. About 50% tested positive for syphilis, 47% for gonorrhea, and 25% in Arusha for chlamydia. No significant association existed between HIV seropositivity and STD prevalence. Another study showed that HIV seroprevalence among the general population had only slightly increased since 1987 which suggests that these prostitutes experienced high HIV seroprevalence earlier in the epidemic. These prostitutes represented a reservoir for STDs including HIV. Unless condom use increases among these women, HIV will spread to the general population. Health education campaigns should expand beyond just provision of condoms and find other means to effectively target these women.
Subject(s)
Sex Work/statistics & numerical data , Sexually Transmitted Diseases/epidemiology , Adolescent , Adult , Female , HIV Seroprevalence , Health Education , Humans , Middle Aged , Prevalence , Seroepidemiologic Studies , Sexually Transmitted Diseases/blood , Sexually Transmitted Diseases/prevention & control , Tanzania/epidemiologyABSTRACT
The enzyme-linked immunosorbent assay (ELISA) is currently the most accepted method used to screen for antibodies to HIV Conventional ELISA assays require from 1.5 to 3.5 hours to complete and an optical density (OD) reader to record results. We have therefore considered the applicability of using rapid tests for the screening of blood donors. The Testpack method is quick to perform; easy to interpret and sensitive. Results indicate that the Testpack method is suitable for the screening of blood donors and in emergency situations
Subject(s)
AIDS Serodiagnosis , Blood Donors , Diagnosis , HIV Antibodies , HIV Infections , LaboratoriesABSTRACT
The enzyme-linked immunosorbent assay (ELISA) is currently the most accepted method used to screen for antibodies to HIV. Conventional ELISA assays require from 1.5 to 3.5 hours to complete and an optical density (OD) reader to record results. We have therefore considered the applicability of using rapid tests for the screening of blood donors. The Testpack method is quick to perform; easy to interpret and sensitive. Results indicate that the Testpack method is suitable for the screening of blood donors and in emergency situations
