Abstract
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.
Highlights
The World Health Organization (WHO) estimates that there are almost 13.7 milion people living with tuberculosis and that the disease kills more young people and adults than any other infectious disease in the world
The rate of sputum conversion at the end of one month of treatment was 73.1% (P < 0.01) while it was 95% (P < 0.05) at the end of the second month
In contrast with previous studies [20, 24, 25], our results indicated no relationship of cavitation with delayed smear conversion, its presence has been significantly associated with a longer time to smear conversion
Summary
The World Health Organization (WHO) estimates that there are almost 13.7 milion people living with tuberculosis and that the disease kills more young people and adults than any other infectious disease in the world.In Morocco, the new cases of tuberculosis in 2008 were 27000, and the incidence was 82/100000 people. Sputum smear-positive (SSP) pulmonary tuberculosis patients are the most significant source of infection for tuberculosis because, when they cough or sneeze, they expel droplet nuclei which carry infectious bacilli [2]. Sputum smear-positive pulmonary tuberculosis patients expel infectious viable bacilli for a period following the commencement of treatment. To determine the time to sputum smear conversion and study the factors influencing it. A prospective study was undertaken at our hospital in Rabat over a six-month period on a cohort of 119 sputum smear positive patients. 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. Patients with high smear grading, miliary, and bilateral radiologic lesions need to be monitored more closely
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