Added value of bleach sedimentation microscopy for diagnosis of pulmonary tuberculosis: cost-effectiveness study

IUATLD Conference, Paris, 200

Added value of bleach sedimentation microscopy for diagnosis of tuberculosis: a cost-effectiveness study.

SETTING: Bleach sedimentation is a method used to increase the diagnostic yield of sputum microscopy for countries with a high prevalence of human immunodeficiency virus (HIV) infection and limited resources. OBJECTIVES: To compare the relative cost-effectiveness of different microscopy approaches in diagnosing tuberculosis (TB) in Kenya. METHODS: An analytical decision tree model including cost and effectiveness measures of 10 combinations of direct (D) and overnight bleach (B) sedimentation microscopy was constructed. Data were drawn from the evaluation of the bleach sedimentation method on two specimens (first on the spot [1] and second morning [2]) from 644 TB suspects in a peripheral health clinic. Incremental cost per smear-positive detected case was measured. Costs included human resources and materials using a micro-costing evaluation. RESULTS: All bleach-based microscopy approaches detected significantly more cases (between 23.3% for B1 and 25.9% for B1+B2) than the conventional D1+D2 approach (21.0%). Cost per tested case ranged between respectively euro 2.7 and euro 4.5 for B1 and B1+D2+B2. B1 and B1+B2 were the most cost-effective approaches. D1+B2 and D1+B1 were good alternatives to avoid using approaches exclusively based on bleach sedimentation microscopy. CONCLUSIONS: Among several effective microscopy approaches used, including sodium hypochlorite sedimentation, only some resulted in a limited increase in the laboratory workload and would be most suitable for programmatic implementation

EROS VARIABLE STARS : FUNDAMENTAL-MODE AND FIRST OVERTONE CEPHEIDS IN THE BAR OF THE LARGE MAGELLANIC CLOUD

We present CCD phase-binned light curves at 490 nm for 97 Cepheid variable stars in the bar of the LMC. The photometry was obtained as part of the French EROS project and has excellent phase coverage, permitting accurate decomposition into Fourier components. We identify as `sinusoidal' or s-Cepheids those stars with periods less than 5.5 d and small second-harmonic components. These stars comprise $\sim$30% of our sample and most form a sequence $\sim$1 mag brighter than the LMC classical Cepheids in the period-luminosity diagram. They are also generally bluer and have lower-amplitude light curves. We infer that the s-Cepheids are first-overtone pulsators because, when their periods are converted to expected fundamental-mode values, they obey a common period-luminosity-colour relation with classical Cepheids. This also confirms the reality of the colour term in the Cepheid period-luminosity-colour relation. Further, the blue edge of the classical Cepheid instability strip agrees well with the theoretical calculations for the fundamental mode made by Chiosi et al. (1993) for the Hertzsprung-Russell and period-luminosity diagrams, but we find that our observed s-Cepheids are $>0.2$ mag brighter and bluer than the Chiosi et al.\ predictions for the first-overtone. We identify a number of features in plots of our stars' Fourier-component amplitude ratios and phase differences. These features have been identified with resonances between different pulsation modes. In the LMC we find these features seem to occur at periods very similar to Galactic ones for classical Cepheids, but at different periods for s-Cepheids. We discover a double-mode Cepheid in the LMC, for which $P({\rm first overtone})/P({\rm fundamental}) = 0.710 \pm 0.001$, very similar to observed ratios for Galactic double-mode Cepheids.Comment: 19 pages, uuencoded compressed PS file, including 14 figures. Accepted for publication in Astronomy and Astrophysics, February-2-199

Eros catalogue of eclipsing binary stars in the bar of the large magellanic cloud

Digitalization is everywhere in publihing process but difficulties still remain on e-books business. Digital libraries show new ways for e-books dissemination. Publishing and libraries economy will be re-built on different foundations in the future

Eros catalogue of eclipsing binary stars in the bar of the large magellanic cloud

Digitalization is everywhere in publihing process but difficulties still remain on e-books business. Digital libraries show new ways for e-books dissemination. Publishing and libraries economy will be re-built on different foundations in the future