Colored Cellophane Use in Sputum Smear Microscopic Examination Performance in Pulmonary Tuberculosis Diagnosis

Introduction: According to the World Health Organization (2020), staining and microscopy are important modalities in tuberculosis (TB) diagnosis, especially in rural areas, for screening, case-finding, and treatment evaluation.

Method: This pilot study compares the use of colored cellophane with standardized microscopy examination of stained sputum smear from seven patients with pulmonary TB in Surabaya Indonesia from March–June 2020. One-hundred forty images were captured and analyzed for contrast ratio and Acid-Fast bacilli count.

Results: The contrast ratio for each acid-fast bacillus and its adjacent pixels were significantly higher in yellow+blue filter group (3.24 ± 0.98) than in no filter group (2.52 ± 0.54). The contrast ratio for greyscaled images of yellow+blue filter group (3.53 ± 1.78) was significantly higher than no filter group (2.18 ± 0.83) (p = 0.001).

Conclusion: Colored cellophane increases contrast ratio and eases microscopic examination, and may potentially increase microscopic observation and detection capability.