Appropriate technology in tuberculosis diagnostics.

First, the statement that the use of the string test “will be hampered by the need for sputum induction” seems to be a misunderstanding: sputum induction added nothing to the results of the string test and was used only as a comparative test for this research. In fact, our findings clearly show that the string test alone offers better diagnostic sensitivity than sputum induction. By obviating the need for sputum induction, it could remove an important risk factor for nosocomial transmission of tuberculosis, particularly in resource-poor settings with a high tuberculosis burden, no isolation facilities, and wards crowded with highly susceptible HIV-infected patients. We would therefore suggest that the string test should supersede sputum induction if these data are borne out in other settings.