Predictors of smear non-conversion among new-treatment pulmonary tuberculosis: a single center case-control study in Indonesia
DOI:
https://doi.org/10.13181/mji.oa.204216Keywords:
microbiological techniques, Mycobacterium, pulmonary tuberculosisAbstract
BACKGROUND Previous studies concluded predictors of smear non-conversion pulmonary tuberculosis (TB) globally as well as in Indonesia. However, there is a limited data in hospital setting. This study aimed to explore predictors of smear non-conversion pulmonary TB in hospital setting.
METHODS A case-control study was conducted to explore predictors of smear nonconversion among new-treatment pulmonary TB in Dr. Kariadi General Hospital from 2017 to 2019. Number of cases and controls have been determined consecutively. Data were collected from secondary data accessed in medical records and directly from subjects. Non-conversion status in the case group was defined as a persistent sputum smear-positive after 2 months of intensive phase of treatment. The subjects’ characteristics i.e., age, sex, BMI, education level, occupational status, and predictors of smear non-conversion, i.e., patient’s compliance, smoking status, alcohol consumption, presence of drugs side effects, health care access, first acid-fast bacilli (AFB) smear grading, diabetes mellitus (DM), housing condition, housing density, and household income were observed. Chi-square test and binary logistic regression were used.
RESULTS 35 subjects were determined in the case group while 76 subjects were the control group and involved in the final analysis. Age, sex, first AFB smear grading, smoking status, housing condition, housing density, and DM were involved in the model of logistic regression. DM (OR = 3.4; 95% CI = 1.19–10.00) and first AFB smear grading (OR = 11.2; 95% CI = 3.86–33.00) were concluded as the predictors of smear nonconversion.
CONCLUSIONS DM and first AFB smear grading were the predictors of smear nonconversion among new-treatment pulmonary TB subjects.
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References
World Health Organization. Global tuberculosis report 2019 [Internet]. World Health Organization; 2019 [cited 2020 Feb]. Available from:, https://www.who.int/tb/publications/global_report/en/.
Nandasena S, Senavirathna C, Munasinghe C, Wijesena C, Sucharitharathna R. Characteristics and sputum conversion of tuberculosis (TB) patients in Kalutara, Sri Lanka. Indian J Tuberc. 2019;66(1):76-80. https://doi.org/10.1016/j.ijtb.2018.04.008
Diktanas S, Vasiliauskiene E, Polubenko K, Danila E, Celedinaite I, Boreikaite E, et al. Factors associated with persistent sputum positivity at the end of the second month of tuberculosis treatment in Lithuania. Tuberc Respir Dis (Seoul). 2018;81(3):233-40. https://doi.org/10.4046/trd.2017.0096
Kayigamba FR, Bakker MI, Mugisha V, De Naeyer L, Gasana M, Cobelens F, et al. Adherence to tuberculosis treatment, sputum smear conversion and mortality: a retrospective cohort study in 48 Rwandan clinics. PLoS One. 2013;8(9):e73501. https://doi.org/10.1371/journal.pone.0073501
D'Souza KA, Zaidi SMA, Jaswal M, Butt S, Khowaja S, Habib SS, et al. Factors associated with month 2 smear non-conversion among category 1 tuberculosis patients in Karachi, Pakistan. J Infect Public Health. 2018;11(2):283-5. https://doi.org/10.1016/j.jiph.2017.06.009
Lee SH, Seo KA, Lee YM, Lee HK, Kim JH, Shin C, et al. Low serum concentrations of moxifloxacin, prothionamide, and cycloserine on sputum conversion in multi-drug resistant TB. Yonsei Med J. 2015;56(4):961-7. https://doi.org/10.3349/ymj.2015.56.4.961
Masjedi MR, Hosseini M, Aryanpur M, Mortaz E, Tabarsi P, Soori H, et al. The effects of smoking on treatment outcome in patients newly diagnosed with pulmonary tuberculosis. Int J Tuberc Lung Dis. 2017;21(3):351-6. https://doi.org/10.5588/ijtld.16.0513
Critchley JA, Restrepo BI, Ronacher K, Kapur A, Bremer AA, Schlesinger LS, et al. Defining a research agenda to address the converging epidemics of tuberculosis and diabetes: part 1: epidemiology and clinical management. Chest. 2017;152(1):165-73. https://doi.org/10.1016/j.chest.2017.04.155
Mlotshwa M, Abraham N, Beery M, Williams S, Smit S, Uys M, et al. Risk factors for tuberculosis smear non-conversion in Eden district, Western Cape, South Africa, 2007-2013: a retrospective cohort study. BMC Infect Dis. 2016;16:365. https://doi.org/10.1186/s12879-016-1712-y
Tama TD, Adisasmita AC, Burhan E. Body mass index and time to sputum smear conversion among acid-fast bacilli (AFB) positive pulmonary tuberculosis patients at RSUP Persahabatan 2012. J Epidemiol Kesehat Indones. 2016;1(1):1-8. Indonesian. https://doi.org/10.7454/epidkes.v1i1.1309
Bineni C, Yarasani P, Ravi Prabhu G. A study on role of sputum conversion rate in management of tuberculosis in South Indian population. Int J Community Med Public Health. 2018;5(4):1419-23. https://doi.org/10.18203/2394-6040.ijcmph20181210
Piparva KG, Jansari G, Singh AP. Evaluation of treatment outcome and adverse drug reaction of directly observed treatment (DOT) plus regimen in multidrug-resistant tuberculosis (MDR-TB) patients at district tuberculosis centre Rajkot. Perspect Clin Res. 2018;9(4):165-9. https://doi.org/10.4103/picr.PICR_165_17.
Muture BN, Keraka MN, Kimuu PK, Kabiru EW, Ombeka VO, Oguya F. Factors associated with default from treatment among tuberculosis patients in Nairobi province, Kenya: a case control study. BMC Public Health. 2011;11:696. https://doi.org/10.1186/1471-2458-11-696
Dangisso MH, Datiko DG, Lindtjørn B. Accessibility to tuberculosis control services and tuberculosis programme performance in southern Ethiopia. Glob Health Action. 2015;8:29443. https://doi.org/10.3402/gha.v8.29443
Low CT, Lai PC, Tse WSC, Tsui CK, Lee H, Hui PK. Exploring tuberculosis by types of housing development. Soc Sci Med. 2013;87:77-83. https://doi.org/10.1016/j.socscimed.2013.03.024
Peltzer K, Louw JS. Prevalence and factors associated with tuberculosis treatment outcome among hazardous or harmful alcohol users in public primary health care in South Africa. Afr Health Sci. 2014;14(1):157-66. https://doi.org/10.4314/ahs.v14i1.24
Maciel EL, Brioschi AP, Peres RL, Guidoni LM, Ribeiro FK, Hadad DJ, et al. Smoking and 2-month culture conversion during antituberculosis treatment. Int J Tuberc Lung Dis. 2013;17(2):225-8. https://doi.org/10.5588/ijtld.12.0426
Lemeshow S, Hosmer DW Jr, Klar J, Lwanga SK. Adequacy of sample size in health studies. World Health Organization; 1990.
Gadallah MA, Mokhtar A, Rady M, El-Moghazy E, Fawzy M, Kandil SK. Prognostic factors of treatment among patients with multidrug-resistant tuberculosis in Egypt. J Formos Med Assoc. 2016;115(11):997-1003. https://doi.org/10.1016/j.jfma.2015.10.002
Jayakody W, Harries AD, Malhotra S, de Alwis S, Samaraweera S, Pallewatta N. Characteristics and outcomes of tuberculosis patients who fail to smear convert at two months in Sri Lanka. Public Health Action. 2013;3(1):26-30. https://doi.org/10.5588/pha.12.0090
Nwokeukwu HI, Awujo D, Emma-Ukeagbu U. Association of sputum conversion and outcome with initial smear grading among new smear positive tuberculosis patients in a Tertiary Health Facility, South East Zone, Nigeria. IOSR J Dent Med Sci. 2013;4(6):21-5. https://doi.org/10.9790/0853-0112125
Viswanathan V, Vigneswari A, Selvan K, Satyavani K, Rajeswari R, Kapur A. Effect of diabetes on treatment outcome of smearpositive pulmonary tuberculosis-a report from South India. J Diabetes Complications. 2014;28(2):162-5. https://doi.org/10.1016/j.jdiacomp.2013.12.003
Underner M, Perriot J, Peiffer G, Meurice JC, Dautzenberg B. Smoking and adherence to anti-tuberculosis treatment Smoking and adherence to anti-tuberculosis treatment. Rev Mal Respir. 2016;33(2):128-44. https://doi.org/10.1016/j.rmr.2015.08.005
Nijenbandring de Boer R, Oliveira e Souza Filho JB, Cobelens F, Ramalho Dde P, Campino Miranda PF, Logo KD, et al. Delayed culture conversion due to cigarette smoking in active pulmonary tuberculosis patients. Tuberculosis. 2014;94(1):87-91. https://doi.org/10.1016/j.tube.2013.10.005
Saffari M, Jolandimi HA, Sehat M, Nejad NV, Hedayati M, Zamani M, et al. Smear grading and the Mantoux skin test can be used to predict sputum smear conversion in patients suffering from tuberculosis. GMS Hyg Infect Control. 2017;12:Doc12. https://doi.org/10.3205/dgkh000297
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