scholarly journals Factors Influencing Sputum Conversion among Smear-Positive Pulmonary Tuberculosis Patients in Morocco

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Khalid Bouti ◽  
Mohammed Aharmim ◽  
Karima Marc ◽  
Mouna Soualhi ◽  
Rachida Zahraoui ◽  
...  

Background. Sputum smear-positive pulmonary tuberculosis patients expel infectious viable bacilli for a period following the commencement of treatment. Objective. To determine the time to sputum smear conversion and study the factors influencing it. Design. A prospective study was undertaken at our hospital in Rabat over a six-month period on a cohort of 119 sputum smear positive patients. Patients were followed up fortnightly. At each followup, specimens were collected and processed for microscopy using standard protocol. Results. 96.6% of our patients completed the study (4 deaths). Sputum conversion rate was 42% after two weeks, 73% after one month, and 95% after two months. Univariate and stepwise regression analysis showed that patients who had high smear grading, miliary, and bilateral radiologic lesions were more likely to undergo delayed sputum conversion (P<0.05). Other factors were thought to influence sputum conversion but were not statistically proven in our study. Conclusion. Since viable bacilli continue to be expelled for up to two months, infection control measures should be maintained for such a time. Patients with high smear grading, miliary, and bilateral radiologic lesions need to be monitored more closely.

RSC Advances ◽  
2018 ◽  
Vol 8 (16) ◽  
pp. 8983-8989
Author(s):  
Xinji Gong ◽  
Yuehua Li ◽  
Jing Wang ◽  
Gang Wu ◽  
Ayinuer Mohemaiti ◽  
...  

Background: Despite great effort to control tuberculosis (TB), low treatment adherence threatens the success of drug therapy, increases the risk of TB transmission, and leads to the development of drug resistance.


2017 ◽  
Vol 8 (1) ◽  
pp. 585
Author(s):  
Radita Ikapratiwi ◽  
Indah Rahmawati ◽  
Joko Mulyanto

Tuberculosis (TB) is considered as the leading killer among infectious diseases because of bacteria resulted in a high number ofmorbidity and mortality world wide. One risk factor for tuberculosisis diabetes mellitus (DM). The prevalence of TB and DM jump together globally, especially in developing countries, including Indonesia. Early and accurate diagnosis of TB cases in the enforcement is sputum smear examination. Monitoring of TB seen through sputum conversion. The purpose of this studyis to determine the duration of sputum conversion difference new case smear positive pulmonary TB patients with and without DM in hospital Prof. Dr.Margono Soekarjo (RSMS) Purwokerto. Thestudy design is observational analytic with cohort retrospective study. Sample of this study was patients who checked their health in Lung Clinis of RSMS Purwokerto obtained total sample of 44 people, consisting of 22 patients clinically diagnosed new cases smear-positive pulmonary TB with DM and 22 patients without DM in 2009 until 2012.Results of this study were analyzed using Fisher Exact Test. pvalues obtainedof 0.000 (p <0.05) (95% CI = 0,288-0,718) with relative risk 0,455. The conclusion is there were significant differences in sputum conversion time between the group of patients suffering from pulmonary uberculosis with and without DM. The conversion of sputum in patients with pulmonary tuberculosis who suffered DM is longer than patients without DM. Relative risk value which is equal to 0.455 which means that patients with DM have pulmonary tuberculosis risk by 0.455 times more likely to experience delays in sputum conversion than TB patients without DM


2021 ◽  
Vol 10 (42) ◽  
pp. 3617-3622
Author(s):  
Dhondiba Haribhau Bhise

BACKGROUND Sputum smear conversion is the negative conversion of the sputum smear at the end of the second month of treatment regimen under the National Tuberculosis Elimination Program (NTEP). When the acid-fast bacillus (AFB) smear comes negative at the end of an intensive phase, the treatment regimen can shift to the continuation phase that indicates bacillary load is a minimum. Although some authors consider the conversion of cultures when the AFB smear is negative, two potent drugs in the continuation phase are sufficient to kill the remaining bacilli. The drug that can kill bacteria in the first 2 days of treatment is called early bactericidal activity (EBA). This can be assessed by the percentage of negative conversion of cultures at the end of the intensive phase of the treatment regimen. EBA is very essential because it reduces the transmission in the community and chances of patient death. When the purpose is to kill as many bacilli as possible in the first few days and weeks of treatment, it is very important to include bactericidal drugs in the treatment regimen so that it reduces the chances of patient death and infectiousness and the negative conversion of the cultures after 2-month treatment regimen is an indication of the bactericidal capacity of the drug. The purpose of this study was to compare sputum smear conversion in daily versus intermittent treatment regimens in diagnosed cases of new sputum smear-positive pulmonary tuberculosis patients. METHODS This retrospective observational study was carried out in the Department of Respiratory medicine and nodal drug resistance tuberculosis centre (DR-TB) at the Government medical college and hospital, Akola. In this study, a total of 120 new patients were taken. 60 patients were given daily and intermittent regimens respectively under NTEP. RESULTS Out of 120 patients, 56 (93.33 %) patients in intermittent and 53 (88.33 %) patients in daily regimen were sputum smear-negative at the end of 2nd month (intensive phase) and at the end of 6th month (continuation phase). 1 patient (1.6 %) remained sputum smear-positive after the intensive phase. That patient was given 1 month of extension of anti-tuberculosis treatment (AKT) in the intensive phase and the patient became sputum negative after 1 month of extension. CONCLUSIONS It was concluded in this study, daily regimens and intermittent regimens were equally effective in negative conversion of the sputum smear at the end of the intensive phase and the end of the continuation phase. Negative conversion of the sputum smear is quite important because the bacillary load will be so low at the end of 2nd month that reduces the chances of patient death and transmission in the community. KEY WORDS Pulmonary Tuberculosis (PTB), Drug-Resistant TB (DR-TB), National Tuberculosis Programme (NTP), Revised National TB Control Program (RNTCP), Intensive Phase (IP), continuation Phase (CP), National Tuberculosis Elimination Program (NTEP).


2019 ◽  
Vol 43 ◽  
pp. 1 ◽  
Author(s):  
Eric Commiesie ◽  
Deborah Stijnberg ◽  
Diana Marín ◽  
Freddy Perez ◽  
Mauro Sanchez

Objective. To identify factors associated with sputum smear nonconversion in patients with pulmonary tuberculosis (PTB) in Suriname. Methods. A case-control study was conducted using routinely-collected surveillance data of PTB cases reported in January 2010 – December 2015 and recorded in the database of the National Tuberculosis Program of Suriname. Cases were smear-positive PTB patients whose sputum results were negative 2 months after treatment initiation. Controls were the smear-positive PTB patients whose sputum results were negative in the same timeframe. Multivariate logistic regression analysis was used to examine associations between potential risk factors and smear conversion. Results. The two age groups ≥ 35 years (35 – 54 years, AOR: 2.7, 95%CI: 1.2 – 6.1; and 55+ years, AOR: 2.5, 95%CI: 1.1 – 5.9) and high bacillary load at baseline (AOR 2.34, 95%CI: 1.2 – 4.8) were significantly associated with delayed smear conversion. Conclusion. The National TB program of Suriname should develop strategies to address patients at higher risk for delayed smear conversion to prevent further spreading and unfavorable treatment outcomes. To better inform decision-making and future studies, the NTP should expand its data collection to include all risk factors for delayed smear conversion.


2021 ◽  
pp. 004947552110421
Author(s):  
S Krishna Singha ◽  
Bineeta Kashyap ◽  
Rajnish Avasthi ◽  
Puneeta Hyanki ◽  
NP Singh ◽  
...  

Our was an observational follow-up study where the aim was to assess the baseline high-sensitivity C-reactive protein levels in 50 smear-positive pulmonary tuberculosis patients in association with socio-clinico-radiological profile and microbiological conversion. Smear and culture conversion of sputum samples at the end of intensive phase of anti-tubercular treatment were recorded. Baseline serum high-sensitivity C-reactive protein estimation was done by ELISA. Mean high-sensitivity C-reactive protein levels at baseline, smear/culture converted and delayed converters were 68.1 ± 22.2 mg/l, 66.7 ± 22.0 mg/l and 91.6 ± 6.7 mg/l, respectively; high-sensitivity C-reactive protein levels were significantly higher in delayed converters as compared to sputum converters. Significantly higher baseline high-sensitivity C-reactive protein levels were seen in patients with bilateral chest X-ray lesions, cavitations, evening rise of temperature, haemoptysis and dyspnoea as compared to those without these features. high-sensitivity C-reactive protein, being a non-specific inflammatory marker could be an adjunct tool for TB prognosis.


1997 ◽  
Vol 25 (3) ◽  
pp. 666-670 ◽  
Author(s):  
Edward E. Telzak ◽  
Barkat A. Fazal ◽  
Cathy L. Pollard ◽  
Glenn S. Turett ◽  
Jessica E. Justman ◽  
...  

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