scholarly journals Treatment outcome in new smear positive pulmonary tuberculosis patients with and without immunosuppression on RNTCP regimen: a comparative observational study

2017 ◽  
Vol 5 (2) ◽  
pp. 384 ◽  
Author(s):  
Radhika Muttath ◽  
Mekkattukkunnel Andrews ◽  
Dinesa Prabhu
Keyword(s):  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Steroid Therapy ◽  
Group Treatment ◽  
Control Group ◽  
Sputum Smear ◽  
Diabetic Patients ◽  
Hiv Patients ◽  
Tuberculosis Patients ◽  
Smear Positive Pulmonary Tuberculosis

Background: Immune status of a patient influences the susceptibility, clinical presentation of tuberculosis and its treatment outcome. Some of the most common conditions associated with immune deficiency includes, human immunodeficiency virus (HIV) infection, diabetes and chronic steroid therapy for any underlying diseases.Methods: A cohort study, enrolled patients with tuberculosis alone (n=51) and those with tuberculosis and immunosuppressed state (patients with HIV, diabetes and those on steroid therapy, n=97).Results: All patients received Directly Observed Treatment Short course (DOTS) regimen implemented through RNTCP. Among the immunosuppressed patients, 32 were HIV patients, 45 of them were diabetic and 20 received chronic steroid therapy. All immunocompetent patients (control) were totally cured but 62.5% and 88.9% of HIV and diabetic patients in the immunosuppressed group were cured. Mortality was high in the immunosuppressed group (18.75% in HIV, and 11.11% in diabetic group). The grade of sputum smear had significant influence on the treatment outcome after adjusting for death and default (p>0.05). After intensive phase, the smear conversion rate were 86.27% in the control group,37.5% in the HIV patients, 22.22% in diabetics and 55% among chronic steroid use. The mortality and cure rate among those who received treatment for diabetes mellitus is comparable with that of immunocompetent group. Treatment prolongation was required for patients in the immunosuppressed group (62.5% in HIV group, 77.7% in diabetes group and 45% in chronic steroid users group).Conclusions: Immunosuppression was a risk factor for increased morbidity and mortality among new smear positive pulmonary tuberculosis patients. Prolonged DOTS regimen requires long-term close follow-up of patients who are immunocompromised.

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 ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Stepwise Regression ◽  
Control Measures ◽  
Sputum Smear ◽  
Tuberculosis Patients ◽  
Infection Control Measures ◽  
Factors Influencing ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Sputum Conversion ◽  
A Prospective Study

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.

scholarly journals Factors associated with treatment outcome in adult tuberculosis patients under directly observed treatment short course in Ludhiana city, Punjab, India: a cohort study

2017 ◽  
Vol 4 (4) ◽  
pp. 933
Author(s):  
Rupali Verma Bagga ◽  
Sarit Sharma ◽  
RK Soni ◽  
Anurag Chaudhary ◽  
Mahesh Satija
Keyword(s):  
Cohort Study ◽  
Treatment Outcome ◽  
Age Groups ◽  
Prolonged Treatment ◽  
Sputum Smear ◽  
Diabetic Patients ◽  
Unfavourable Outcome ◽  
Tuberculosis Patients ◽  
Factors Associated ◽  
Directly Observed Treatment

Background: Tuberculosis (TB) is a communicable disease requiring prolonged treatment and poor adherence to a prescribed treatment increases the risk of morbidity, mortality and spread of disease in the community. Objective was to study factors associated with treatment outcome in adult Tuberculosis patients on directly observed treatment short (DOTS) course in Ludhiana city, Punjab, India.Methods: The present study was a community based prospective cohort study. It was conducted in the two tuberculosis units (TU) of Ludhiana city, Punjab, India. A total of 221 registered DOTS patients were taken as study subjects and were followed during the course of treatment to observe their treatment outcome. The information was collected on a pre-designed semi-structured questionnaire through personal interviews.Results: Out of 221, 183 (82.8%) subjects had favorable outcome, 35 (15.8%) had unfavourable outcome and 3 (1.4%) were transferred out. The comparison between favorable and unfavourable treatment was found be statistically significant with respect to different age groups, problems faced by subjects to reach DOTS centre, diabetes, sputum smear status, site of tuberculosis involvement and side effects of treatment.Conclusions: Elderly and diabetic patients were found to have higher unfavourable outcome. There is need for special provisions for older age groups, illiterates and for lower socio-economic status (SES) in the form of counselling for old people and health insurance for those belonging to lower SES. Keeping in mind the default rate of the present study, initial counselling, periodic motivation of patients and prompt defaulter retrieval action would be beneficial.

scholarly journals Microorganisms isolated at admission and treatment outcome in sputum smear-positive pulmonary tuberculosis

2019 ◽  
Vol 25 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Satoru Ishikawa ◽  
Hidetoshi Igari ◽  
Kazutaka Yamagishi ◽  
Shin Takayanagi ◽  
Fumio Yamagishi
Keyword(s):  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Smear Positive Pulmonary Tuberculosis

scholarly journals Sputum Smears Conversion in Daily Versus Intermittent Treatment Regimen in New Sputum Smear Positive Pulmonary Tuberculosis Patients - A Retrospective Study

2021 ◽  
Vol 10 (42) ◽  
pp. 3617-3622
Author(s):  
Dhondiba Haribhau Bhise
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Regimen ◽  
Sputum Smear ◽  
Patient Death ◽  
Continuation Phase ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
National Tuberculosis ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Negative Conversion

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).

scholarly journals Determinants of sputum smear nonconversion in smear-positive pulmonary tuberculosis patients in Suriname, 2010 – 2015

2019 ◽  
Vol 43 ◽  
pp. 1 ◽  
Author(s):  
Eric Commiesie ◽  
Deborah Stijnberg ◽  
Diana Marín ◽  
Freddy Perez ◽  
Mauro Sanchez
Keyword(s):  
Risk Factors ◽  
Pulmonary Tuberculosis ◽  
Age Groups ◽  
Multivariate Logistic Regression Analysis ◽  
Sputum Smear ◽  
Tuberculosis Patients ◽  
National Tuberculosis ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Potential Risk Factors ◽  
Control Study

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.

Sign in / Sign up

Export Citation Format

Share Document