TY - JOUR T1 - Two sputum samples at once for diagnosis of tuberculosis in Africa has equivalent sensitivity and specificity to the standard initial sample followed by a morning sample strategy JF - Evidence Based Medicine JO - Evid Based Med SP - 173 LP - 174 DO - 10.1136/ebm.2011.100197 VL - 16 IS - 6 AU - Nauman Safdar AU - Kamran Siddiqi Y1 - 2011/12/01 UR - http://ebm.bmj.com/content/16/6/173.abstract N2 - Commentary on: Cuevas LE, Yassin MA, Al-Sonboli N, et al. A multi-country non-inferiority cluster randomized trial of frontloaded smear microscopy for the diagnosis of pulmonary tuberculosis. PLoS Med 2011;8:e1000443. Tuberculosis (TB) persists as a major cause of human morbidity and mortality, affecting almost 9.4 million people and causing 1.8 million deaths yearly worldwide.1 Examining Mycobacterium tuberculosis bacilli, using light microscopy with Ziehl–Neelsen stain, is still considered the most specific, cost-effective, quick and reliable test for the diagnosis of pulmonary TB.2 In recent years, new diagnostics such as ‘Xpert MTB/RIF’ (97.6% sensitivity and 99.2% specificity) have emerged and are being endorsed by the WHO. The ‘Gene Xpert’ has been recommended by WHO to use as a first-line test for multidrug-resistant TB or HIV-associated TB.3 Collecting and processing quality sputum specimens for microscopy is a manageable process but requires trained and dedicated laboratory staff and motivated patients. In reality, most of the peripheral laboratories in high TB burden countries … ER -