Bleach processed smear for Acid fast bacilli staining in Papua New Guinea

The conventional method of processing sputum for acid fast bacilli microscopy has been a primary tool for laboratory diagnosis of pulmonary tuberculosis in Papua New Guinea. In routine preparation, untreated sputum is directly smeared on a glass slide without undergoing any stage of processing. Mounting evidence suggests that direct smearing is less sensitive and, to a certain degree, compromises infection control. A few alternatives for processing sputum have been recommended in the literature; however, their consumables are not easily accessible and are expensive for wide use in rural laboratories. The bleach concentration and processing method appears to be the most preferable choice because bleach is inexpensive, readily available, and has bactericidal properties.