Abstract
Introduction: Successful control of tuberculosis (TB) depends on early and effective treatment. However, there is variability in the response to therapy for sensitive TB. This is due to several factors.
Aim of the study: To identify factors associated with delayed sputum smear conversion in patients treated for TB.
Method: Retrospective comparative study of 200 patients followed up between 2010 and 2014 for pulmonary TB. We defined 2 groups: G1(sputum smear conversion delay >2 months) and G2: (delay≤2 months).
Results: The medium age is 40 years ±15 with male predominance. Delayed sputum smear conversion occurred within 40 patients (20%). Univariate analysis study showed that these factors were significantly associated with persistent smear positivity: age>50 years (58% vs 26%; p<0.05), male gender (81% vs 60%;p<0.02), access to health insurance (58% vs 39%;p=0.039), tobacco smoking(67% vs 50%; p=0.054), alcoholism (34% vs 10% ;p<0.05), drug using (8% vs 2%; p=0.03), previous TB (11% vs 5%), diabetis (10% vs 3%;p<0.05), prolonged consultation and confirmation delay (135 days vs 76;p=0.007)(77 days vs 16;p<0.001), cavitations at chest radiograph (73% vs 46%; p=0.004),bilateral radiological involvement (32% vs 18%;p<0.05) and smear grade >2+(57% vs 26% ;p<0.05). Multvariate analysis showed that older age, male gender, previous TB, cavitations and higher bacillary load were independent factors associated with delayed conversion sputum smear.
Conclusion: TB patients represents a major source of infectivity.To reduce this risk, efforts have to be done to control factors intervening in to sputum smear conversion delay.
- Copyright ©ERS 2015