scholarly journals Determining the risk factors associated with delayed sputum conversion at the end of the intensive phase among tuberculosis patients

2021 ◽  
Vol 27 (8) ◽  
pp. 755-763
Author(s):  
Zohra Bhatti ◽  
Amer Hayat Khan ◽  
Syed Azhar Syed Sulaiman ◽  
Madeeha Laghari ◽  
Irfhan Ali Bin Hyder Ali
Keyword(s):  
Conversion Rate ◽  
Control Programme ◽  
Blue Collar ◽  
Sputum Smear ◽  
Multivariable Logistic Regression Analysis ◽  
Intensive Phase ◽  
Predicting Factors ◽  
Sputum Conversion ◽  
The Government ◽  
Collection Form

Background: In pulmonary tuberculosis (PTB), the sputum conversion rate at 2 months is frequently used to evaluate treatment outcomes and effectiveness of a TB control programme. Aims: The study aimed to estimate the rate of delayed sputum conversion and explore its predicting factors at the end of the intensive phase among smear-positive PTB (PTB +ve) patients. Methods: A 3-year retrospective study was conducted in the government hospital in Pulau Pinang from 2016 to 2018. During the study, a standardized, data collection form was used to collect data from the patient record. Patients aged over 18 years were recruited. Multivariable logistic regression analysis was used to identify significant independent variables associated with delayed sputum conversion. Results: A total 1128 of PTB patients were recorded visiting the TB clinic, 736 (65.2%) were diagnosed as PTB +ve; of these, 606 (82.3%) PTB +ve had a record of sputum conversion at the end of the intensive phase. Age ≥ 50 years, blue-collar jobs, smoking, heavy bacillary load, relapsed and treatment interrupted were significantly (P < 0.05) associated with delayed sputum conversion. Delayed sputum conversion rate at the end of the intensive phase was 30.5%. Conclusion: The rate of sputum smear conversion in the intensive phase of treatment was independently associated with high sputum smear grading at diagnosis, relapsed and treatment interrupted categories, old age and blue-collar occupations.

scholarly journals A study on role of sputum conversion rate in management of tuberculosis in South Indian population

2018 ◽  
Vol 5 (4) ◽  
pp. 1419 ◽  
Author(s):  
Chandrasekhar Bineni ◽  
Pradeep Yarasani ◽  
G. Ravi Prabhu
Keyword(s):  
Conversion Rate ◽  
Sputum Smear ◽  
South Indian Population ◽  
Intensive Phase ◽  
South Indian ◽  
Short Course ◽  
Directly Observed Treatment ◽  
Sputum Conversion ◽  
The Difference

Background: Directly observed treatment short course (DOTS) is the currently recommended control strategy for tuberculosis. Even after intensive phase of directly observed treatment short course, there is delayed sputum smear conversion in some patients due to multiple factors. The present study was undertaken to study the role of sputum conversion in management of tuberculosis.Methods: A total of 229 patients with smear positive Tuberculosis cases of both Category-I and Category-II from DOTS centre in tuberculosis, S.V.R.R. Government General Hospital, Tirupati, A.P were enrolled and registered for the present study. Consent was taken from the patients to study the role of Sputum conversion rate importance in management of Tuberculosis in South Indian population.Results: The sputum conversion rate has been found to be higher in Category I (93.2%) compared to that of Category II (80.8%) and the difference is also found to be statistically significant. The sputum conversion rate has been found to be higher in those who were one + initial grade of sputum 96.1% followed by scanty grading 93.3%.Conclusions: The present study suggests that special attention should be given to patients enrolled for DOTS II regimen to improve sputum conversion rate in management of tuberculosis.

scholarly journals TO ASSESS THE RESPONSE AND OUTCOME OF THE TB PATIENTS REGISTERED AT DTC REWA OF CENTRAL INDIA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Anjana Niranjan ◽  
Sanjeev Sharma ◽  
Rohit Trivedi ◽  
Pahram Adhikari ◽  
Achala Jain ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Conversion Rate ◽  
The Body ◽  
Treatment Result ◽  
Sputum Smear ◽  
Prospective Longitudinal Study ◽  
Pulmonary Tb ◽  
Sputum Conversion ◽  
Extra Pulmonary ◽  
Prospective Longitudinal

Background-Tuberculosis is a highly infectious disease caused by Mycobacterium tuberculosis. The disease primarily affects lungs so it known as Pulmonary TB and other tissues of the body which is known as Extra-pulmonary TB. The vast majority of TB deaths are in the developing world left untreated, Tuberculosis is treatable with a course of antibiotics. The most successful strategy to treat TB patients is DOTS. Material and Method: This is a Prospective Longitudinal  study conducted  among the patients attending DOTS center of DTC located at S.G.M.H. campus  Rewa for the Treatment  provided under of a definitive time period ( as per RNTCP, last quarter of 2014) from 1st Oct to 31st Dec 2014. Aim & Objective:  1. To observe the sputum conversion rate of study population. 2. To find out the outcome of treatment. Result: 69.92%were pulmonary tuberculosis and 30.07% was Extra-pulmonary tuberculosis and sputum conversion rate of Pulmonary TB cases at the end of IP in new sputum smear positive cases was 96.66% but at the end of 5 month it was 100%. In retreatment cases Sputum Conversion rate at the end of IP was 89.28% and at the end of 5 month 92.85%.and overall treatment success rate were 90.97%.  Conclusion: At the end of treatment as per DOTS schedules sputum smear examination is mandatory to know the exact treatment cure rate.  Key words: Pulmonary, Extra-Pulmonary, Sputum Conversion, cured, Treatment completed, Defaulter etc.

scholarly journals FIXED-DOSE COMBINATION VERSUS SEPARATE ANTITUBERCULOSIS FORMULATIONS IN PULMONARY TUBERCULOSIS PATIENTS: EVALUATION OF EFFECTIVENESS AND SAFETY

2018 ◽  
Vol 10 (1) ◽  
pp. 208
Author(s):  
Rimenda Sitepu ◽  
Purwantyastuti Ascobat ◽  
Flora Ekasari ◽  
Insti Instiaty
Keyword(s):  
Treatment Phase ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Sputum Smear ◽  
Chi Square ◽  
Extended Phase ◽  
Intensive Phase ◽  
First Category ◽  
Sputum Conversion ◽  
Dose Combination

Objective: This study aimed to compare the effectiveness and safety of fixed dose combination (FDC) versus separate (separate formulation [SF])antituberculosis (TB) formulations in patients with bacteriologically confirmed pulmonary TB.Methods: Data were collected retrospectively from patient records, which included all newly diagnosed bacteriologically confirmed pulmonaryTB patients treated with first category FDC or SF between January 2014 and January 2017 at the Dr. Esnawan Antariksa Hospital. The efficacy ofthe formulations was determined according to acid-fast bacilli (AFB) sputum smear conversion at the end of the intensive phase (month 2), after6 months of therapy, and after the extended treatment phase (month 3). Adverse drug reactions (ADRs) during treatments were recorded as safetyoutcomes. Chi-square tests were used to analyze the differences between the groups.Results: On comparing patients treated with FDC (n=33) and SF (n=30), rates of sputum conversions did not differ significantly after 2 months(83.3% vs. 78.7%, p=0.693) and the intensive phase was extended by 1 month for patients with conversion failures at this time point. One of sevenpatients in the FDC group did not achieve sputum conversion during the extended phase and was recorded as a medication failure. At the end ofcontinuation phase, all other subjects achieved sputum conversion. The overall frequencies of ADRs were not significantly higher in the FDC groupthan that in the SF group (36.4% vs. 23.3%, p=0.260).Conclusion: No differences in effectiveness and safety profiles were identified between first category FDC and separate anti TB formulations.

scholarly journals Vitamin D as an Adjunctive Treatment to Standard Drugs in Pulmonary Tuberculosis Patients: An Evidence-Based Case Report

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Diajeng Ayesha Soeharto ◽  
Diana Ashilah Rifai ◽  
Stella Marsudidjadja ◽  
Aisha Emilirosy Roekman ◽  
Chadijah Karima Assegaf ◽  
...  
Keyword(s):  
Vitamin D ◽  
Adjunctive Therapy ◽  
Conversion Rate ◽  
Vitamin D Supplementation ◽  
Adjunctive Treatment ◽  
Current Evidence ◽  
Sputum Smear ◽  
Evidence Based ◽  
Sputum Conversion

Background. Vitamin D has a prominent role in the body’s innate immunity as it is important in the maintenance of macrophages and monocytes and its function in defending against infections.In-vitrostudies have established vitamin D’s potential role in tuberculosis (TB) infection, in that it restrictsMycobacterium tuberculosisgrowth, thus implying the potential benefit of vitamin D as an adjunctive treatment for TB. However, clinical trials and reviews have contradicting findings regarding the true clinical efficacy of adjunctive vitamin D, particularly in reducing the sputum conversion rate (SCR).Objective. This study aims to update the current evidence regarding vitamin D supplementation as an adjunctive treatment in achieving the smear sputum conversion rate (SCR) among pulmonary TB patients.Method. A comprehensive search was conducted in October 2018 in PubMed-NCBI, MEDLINE-OVID, SCOPUS-Elsevier, and Cochrane. The selection of studies was done as per the predetermined inclusion and exclusion criteria of this EBCR and resulted in the inclusion of 11 eligible studies (8 RCTs and 3 systematic reviews). The selected studies were then critically appraised for their validity, importance, and applicability according to the CEBM (Centre for Evidence-Based Medicine) appraisal tools.Results. Overall, most of the trials showed no statistically significant changes in terms of the proportion of TB patients with a negative sputum smear conversion in the group treated with an adjunctive therapy vs. the group treated with standard antituberculosis therapy alone. Only one trial showed significant results, which was conducted in a population of TB patients with vitamin D deficiency. Furthermore, overall the reviews showed no significant change in the 8-week sputum smear conversion after treatment within the group given vitamin D in comparison to those who were not.Conclusion. Vitamin D as adjunctive therapy in TB patients shows no clinical improvement in terms of sputum conversion to antituberculosis management.

scholarly journals Review of Organism Density and Bacteriologic Conversion of Sputum among Tuberculosis Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Francis Adjei Osei ◽  
Anthony Enimil ◽  
Daniel Ansong ◽  
Dennis Odai Laryea ◽  
Nicholas Karikari Mensah ◽  
...  
Keyword(s):  
Conversion Rate ◽  
Tertiary Hospital ◽  
Acid Fast Bacillus ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Tuberculosis Patients ◽  
Number Of Patients ◽  
Increasing Trend ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Sputum Conversion

Objective. This study sought to describe the trend of sputum organism density and the rate of bacteriological conversion among smear positive TB patients assessing care at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Methods. We conducted a retrospective patient folder review from January 2013 to March 2016 at the KATH, a tertiary hospital in Ghana. The data was entered into Microsoft Access database and exported into STATA for analysis. We applied basic descriptive statistics to study variables. Sputum conversion rate (SCR) was estimated using the number of negative tests recorded over a period (numerator) and the number of patients reported in the same period (denominator) and expressed as a percentage. Results. A total of 278 patient records with sputum smear positive at onset were studied. Before treatment sputum density detected in smear microscopy was as follows: 1 acid-fast bacillus (+) (n=114), scanty (n=19), ++ (n=67), and +++ (n=78). We recorded sputum conversion rate of 80.90%, 94.56%, and 98.31% in the intensive, continuation, and completion phases, respectively. Conclusion. This study has shown an increasing trend in sputum conversion of smear positive pulmonary tuberculosis and an increasing trend in loss to follow-ups among tuberculosis patients on treatment.

Study to Evaluate Efficacy of Vajravatakmaņdura in Iron Deficiency Anemia in Adolescent Girls: A Randomized Controlled Trial

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Rashmi Pareek Ayatullah Hosne Asif ◽  
Nisha Kumari Ojha
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Adolescent Girls ◽  
Controlled Trial ◽  
Control Programme ◽  
Deficiency Anemia ◽  
Group A ◽  
The Government ◽  
Trial Drug ◽  
And Control

Background: Anemia in adolescent girls possess greatest burden on their health as it leads to poor cognitive development, poor reproductive health and if not treated may lead to intrauterine growth retardation in their developing fetus. The prevalence of anemia among adolescent is 27% in developing country and 6% in developed country. The Government of India has launched National Anemia Control Programme, to prevent and control anaemia in children and adolescents. But the problem is still persisting because of many issues like - poor palatability, intolerance to the drug used, poor absorption of the drugs used, constipation, discoloration of stool, unpleasant odor and taste etc. result in poor compliance and therefore non adherence to the therapy which finally results in poor improvement. By looking at the magnitude of the problem, an Ayurveda drug Vajravatakmandura has been selected for the study and the present study was undertaken to evaluate the efficacy of the trial drug in iron deficiency anemia in adolescent girls. Material and methods: 100 subjects satisfying inclusion and exclusion criteria were selected and were randomly divided in two groups. In group A, the trial drug Vajravatakmaņdura was administered and in group B, IFA tablets were given for two month of duration with follow up at every fortnight. Result: Both the trial and control groups showed extremely significant result over subjective parameters. Trial drug Vajravatakmaņdura in group A was found more effective over the subjective parameters - weakness, palpitation, pallor and loss of appetite with % gain of 39.77%, 39.39%, 39.17%, 38.09% respectively. Statistical analysis between before and after treatment findings of objective parameters, extremely significant (P less than 0.0001) improvement was found in both groups in all parameters, except for RBC count in group A, which was significant. No adverse effects were reported during entire period of study by any of the patients in trial group treated with trial drug. Conclusion: The trial drug “Vajravatakmandura” is effective, safe and palatable for the management of iron deficiency anemia in adolescent girls.

scholarly journals Predictors of iron consumption for at least 90 days during pregnancy: Findings from National Demographic Health Survey, Pakistan (2017–2018)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sumera Aziz Ali ◽  
Savera Aziz Ali ◽  
Shama Razzaq ◽  
Nayab Khowaja ◽  
Sarah Gutkind ◽  
...  
Keyword(s):  
Health Survey ◽  
Rural Areas ◽  
Iron Supplementation ◽  
Wealth Index ◽  
Prevalence Ratio ◽  
Deficiency Anemia ◽  
Multivariable Logistic Regression Analysis ◽  
Demographic Health Survey ◽  
Sampling Weights ◽  
The Government

Abstract Background Iron supplementation is considered an imperative strategy for anemia prevention and control during pregnancy in Pakistan. Although there is some evidence on the predictors of iron deficiency anemia among Pakistani women, there is a very limited understanding of factors associated with iron consumption among Pakistani pregnant women. Thus, this study aimed to investigate the predictors of iron consumption for at least ≥90 days during pregnancy in Pakistan. Methods We analyzed dataset from the nationally representative Pakistan Demographic Health Survey 2017–2018. The primary outcome of the current study was the consumption of iron supplementation for ≥90 days during the pregnancy of the last birth. Women who had last childbirth 5 years before the survey and who responded to the question of iron intake were included in the final analysis (n = 6370). We analyzed the data that accounted for complex sampling design by including clusters, strata, and sampling weights. Results Around 30% of the women reported consumed iron tablets for ≥90 days during their last pregnancy. In the multivariable logistic regression analysis, we found that factors such as women’s age (≥ 25 years) (adjusted prevalence ratio (aPR) = 1.52; 95% CI: 1.42–1.62)], wealth index (rich/richest) (aPR = 1.25; [95% CI: 1.18–1.33]), primary education (aPR = 1.33; [95% CI: 1.24–1.43), secondary education (aPR = 1.34; [95% CI: 1.26–1.43), higher education (aPR = 2.13; [95% CI: 1.97–2.30), women’s say in choosing husband (aPR = 1.68; [95% CI: 1.57–1.80]), ≥ five antenatal care visits (aPR =2.65; [95% CI (2.43–2.89]), history of the last Caesarian-section (aPR = 1.29; [95% CI: 1.23–1.36]) were significantly associated with iron consumption for ≥90 days. Conclusion These findings demonstrate complex predictors of iron consumption during pregnancy in Pakistan. There is a need to increase the number of ANC visits and the government should take necessary steps to improve access to iron supplements by targeting disadvantaged and vulnerable women who are younger, less educated, poor, and living in rural areas.

scholarly journals Should Sputum Smear Examination Be Carried Out at the End of the Intensive Phase and End of Treatment in Sputum Smear Negative Pulmonary TB Patients?

PLoS ONE ◽  
2012 ◽  
Vol 7 (11) ◽  
pp. e49238 ◽  
Author(s):  
Sumit Malhotra ◽  
Sanjay P. Zodpey ◽  
Shivani Chandra ◽  
Ram Pal Vashist ◽  
Srinath Satyanaryana ◽  
...  
Keyword(s):  
Sputum Smear ◽  
Intensive Phase ◽  
Pulmonary Tb ◽  
Smear Examination ◽  
End Of Treatment ◽  
Smear Negative ◽  
Sputum Smear Examination

scholarly journals Baseline Xpert MTB/RIF ct values predict sputum conversion during the intensive phase of anti-TB treatment in HIV infected patients in Kampala, Uganda: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juliet Namugenyi ◽  
Joseph Musaazi ◽  
Achilles Katamba ◽  
Joan Kalyango ◽  
Emmanuel Sendaula ◽  
...  
Keyword(s):  
Bacterial Load ◽  
Sputum Smear ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Cut Point ◽  
Ct Value ◽  
Tb Treatment ◽  
Drug Concentrations ◽  
Unit Increase ◽  
Sputum Conversion

Abstract Background In resource-limited settings, sputum smear conversion is used to document treatment response. Many People living with HIV (PLHIV) are smear-negative at baseline. The Xpert MTB/RIF test can indirectly measure bacterial load through cycle threshold (ct) values. This study aimed to determine if baseline Xpert MTB/RIF could predict time to culture negativity in PLHIV with newly diagnosed TB. Methods A subset of 138 PLHIV from the ‘SOUTH’ study on outcomes related to TB and antiretroviral drug concentrations were included. Bacterial load was estimated by Mycobacterium Growth Indicator Tubes (MGIT) culture time-to-positivity (TTP) and Lowenstein Jensen (LJ) colony counts. Changes in TTP and colony counts were analyzed with Poisson Generalised Estimating Equations (GEE) and multilevel ordered logistic regression models, respectively, while time to culture negativity analysed with Cox proportional hazard models. ROC curves were used to explore the accuracy of the ct value in predicting culture negativity. Results A total of 81 patients (58.7%) were males, median age 34 (IQR 29  ̶ 40) years, median CD4 cell count of 180 (IQR 68  ̶ 345) cells/μL and 77.5% were ART naive. The median baseline ct value was 25.1 (IQR 21.0  ̶ 30.1). A unit Increase in the ct value was associated with a 5% (IRR = 1.05 95% CI 1.04  ̶ 1.06) and 3% (IRR = 1.03 95% CI 1.03  ̶ 1.04) increase in TTP at week 2 and 4 respectively. With LJ culture, a patient’s colony grade was reduced by 0.86 times (0R = 0.86 95% CI 0.74  ̶ 0.97) at week 2 and 0.84 times (OR = 0.84 95% CI 0.79  ̶ 0.95 P = 0.002) at week 4 for every unit increase in the baseline ct value. There was a 3% higher likelihood of earlier conversion to negativity for every unit increase in the ct value. A ct cut point ≥28 best predicted culture negativity at week 4 with a sensitivity of 91. 7% & specificity 53.7% while a cut point ≥23 best predicted culture negativity at week 8. Conclusion Baseline Xpert MTB/RIF ct values predict sputum conversion in PLHIV on anti-TB treatment. Surrogate biomarkers for sputum conversion in PLHIV are still a research priority.

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