Multicentre evaluation of Ziehl-Neelsen and light-emitting diode fluorescence microscopy in China

H. Xia, Y. Y. Song, B. Zhao, K. M. Kam, R. J. O'Brien, Z. Y. Zhang, H. Sohn, W. Wang, Y. L. Zhao

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


OBJECTIVE: To assess the feasibility of using light-emitting diode fluorescence microscopy (LED-FM) in peripheral laboratories in China. DESIGN: The performance of LED-FM and Ziehl-Neelsen (ZN) microscopy was compared on slides directly prepared from the sputum of tuberculosis (TB) suspects and follow-up patients on treatment. The examination time, fading of fluorescence-stained slides, average unit cost and qualitative user appraisal of LED-FM were also analysed. RESULTS: Among 11 276 slides, the smear-positive rate for LED-FM was 11.2% (1263/11 276), 2.6% (294/11 276) higher than that of ZN (8.6%, 969/11 276; χ2 263.5, P < 0.05). The examination time for LED-FM (120.0 ± 38.9 seconds) was shorter than that for ZN (206.3 ± 75.9 s; t = 28.12, P < 0.05). For smear fading, quantitative and qualitative errors occurred within respectively 7.8 and 7.7 weeks. The average unit costs for ZN and LED-FM were respectively US$2.20 ± 0.58 and US$1.97 ± 0.71 (t = 5.08, P < 0.05). LED-FM was accepted by most laboratory technicians. CONCLUSION: LED-FM compared favourably with ZN, with a higher smear-positive detection rate, a shorter examination time and lower unit examination cost. LED-FM may be an alternative to ZN as a cost-effective method for detecting bacilli in peripheral laboratories in China.

Original languageEnglish (US)
Pages (from-to)107-112+i
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number1
StatePublished - Jan 1 2013
Externally publishedYes


  • Light-emitting diode fluorescence microscopy
  • Pulmonary tuberculosis
  • Smear microscopy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases


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