Light wave filtration by colored cellophane to optimize microscopic contrast ratio in pulmonary tuberculosis sputum observation

Daniel Edbert, Ni Made Mertaniasih, Pepy Dwi Endraswari, Eko Budi Koendhori

Research output: Contribution to journalArticlepeer-review


Introduction: Indonesia has the second highest number of Tuberculosis (TB) in the world and tuberculosis still pose as a global health priority problem. For the diagnostics, microscopy is still one of important modalities in TB diagnosis especially in peripheral areas for screening, case-finding, and treatment evaluation. The use of microscopy is limited to operator visual burden and specimen load. This study aims to modify the use of the microscope by using everyday item to increase microscope operator workload. Method: This is an analytic study of the use of colored cellophane in microscopic examination of sputum smear from 24 pulmonary TB patients from Jakarta and Surabaya. The sputum samples were confirmed positive by standardized ZN-AFB microscopy and/or Xpert MTB/RIF. Each sputum were made into two slides, for each slide, 10 oil immersion fields were captured using Optilab microscope camera mounted on microscope. A total of 480 data pairs were analysed by comparing color characteristic of acid-fast bacilli pixels and its adjacent background pixels and by counting Acid fast Bacilli for each observation field. IUATLD scale were also observed by 3 operators. Results: Contrast ratio for each AFB and its adjacent pixels were significantly higher in groups using cellophane filter than without using filter (p = 0.001). AFB identification per image acquired using filter were not significantly higher (p=0.815). Conclusion: Colored cellophane increases contrast ratio and eases microscopic examination, thus increases sputum smear microscopic observation capability. Also it might increase identification capability with digital image processing.

Original languageEnglish
Article number254
Publication statusPublished - 2022


  • Acid-fast staining
  • Microscopy
  • Sputum
  • Tuberculosis


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