ArticlePloS one2018
Low cost automated whole smear microscopy screening system for detection of acid fast bacilli.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 19 citations in OpenAlex.
- A smear test aiding with an automated slide reader acquires equivalent sensitivity to MGIT960 culture in pulmonary tuberculosis diagnosis.Microbiology spectrum · 2026Article
- Between Achievement and Challenge: Examining China's Tuberculosis Control Pathway and Future Directions from a Global Perspective.China CDC weekly · 2026Article
- Retrospective validation of MetaSystems' deep-learning-based digital microscopy platform with assistance compared to manual fluorescence microscopy for detection of mycobacteria.Journal of clinical microbiology · 2024Article
- The performance of tongue swabs for detection of pulmonary tuberculosis.Frontiers in cellular and infection microbiology · 2023Article
- Evaluation of MetaSystems Automated Fluorescent Microscopy System for the Machine-Assisted Detection of Acid-Fast Bacilli in Clinical Samples.Journal of clinical microbiology · 2022Article
- The state of the art for artificial intelligence in lung digital pathology.The Journal of pathology · 2022Review
- A New Artificial Intelligence-Based Method for Identifying Mycobacterium Tuberculosis in Ziehl-Neelsen Stain on Tissue.Diagnostics (Basel, Switzerland) · 2022Article
- Microscopic Imaging Methods for Organ-on-a-Chip Platforms.Micromachines · 2022Review
- Pneumonia caused by Mycobacterium tuberculosis.Microbes and infectionArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn countries with high tuberculosis (TB) burden, there is urgent need for rapid, large-scale screening to detect smear-positive patients. We developed a computer-aided whole smear screening system that focuses in real-time, captures images and provides diagnostic grading, for both bright-field and fluorescence microscopy for detection of acid-fast-bacilli (AFB) from respiratory specimens.
objectivesTo evaluate the performance of dual-mode screening system in AFB diagnostic algorithms on concentrated smears with auramine O (AO) staining, as well as direct smears with AO and Ziehl-Neelsen (ZN) staining, using mycobacterial culture results as gold standard.
methodsAdult patient sputum samples requesting for M. tuberculosis cultures were divided into three batches for staining: direct AO-stained, direct ZN-stained and concentrated smears AO-stained. All slides were graded by an experienced microscopist, in parallel with the automated whole smear screening system. Sensitivity and specificity of a TB diagnostic algorithm in using the screening system alone, and in combination with a microscopist, were evaluated.
resultsOf 488 direct AO-stained smears, 228 were culture positive. These yielded a sensitivity of 81.6% and specificity of 74.2%. Of 334 direct smears with ZN staining, 142 were culture positive, which gave a sensitivity of 70.4% and specificity of 76.6%. Of 505 concentrated smears with AO staining, 250 were culture positive, giving a sensitivity of 86.4% and specificity of 71.0%. To further improve performance, machine grading was confirmed by manual smear grading when the number of AFBs detected fell within an uncertainty range. These combined results gave significant improvement in specificity (AO-direct:85.4%; ZN-direct:85.4%; AO-concentrated:92.5%) and slight improvement in sensitivity while requiring only limited manual workload.
conclusionOur system achieved high sensitivity without substantially compromising specificity when compared to culture results. Significant improvement in specificity was obtained when uncertain results were confirmed by manual smear grading. This approach had potential to substantially reduce workload of microscopists in high burden countries.
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