Abstract
BackgroundThe sputum smear bacilliary load is a fundamental indicator of the level of infectiousness in DR-TB patients. However, evidence on DR-TB sputum smear grading and its factors in the study setting is limited. This study was aimed to determine the level of sputum smear grading and associated factors among DR-TB patients in Ethiopia.MethodsThis was an institution based cross-sectional study on 520 bacteriological confirmed pulmonary DR-TB patients from September 2010 to December 2017 in the northwest Ethiopia. Epidata 4.2.00 and SPSS 20 were used for data entry and management, respectively. Ordinary logistic regression was fitted. A cut of p-value less than 0.05 in the multivariable ordinary logistic regression was considered to declare statistically significant variables.ResultsOf all 520 bacteriological confirmed pulmonary DR-TB patients; 34.42% had 3+, 15.77% had 2+, 18.27% had 1+, 15.19% had scanty, and 16.35% had negative sputum smear grading results. The odds of having higher sputum smear grades were significantly associated with the patient’s educational status of secondary (Adjusted Odds Ratio (AOR) = 0.43, 95% Confidence Interval (CI): 0.21, 0.89), body mass index of 16 to 18.49 kg/m2 (AOR = 1.81, 95%CI: 1.16, 2.84), and TB treatment history of two and more times (AOR = 1.78, 95%CI: 1.24, 2.55).ConclusionsMore than a third of the bacteriological confirmed pulmonary DR-TB patients in the study setting was highly infectious with the highest bacillary load. The odds of having a high bacillary load were significantly associated with the patient’s TB treatment history, nutritional, and educational status.
Highlights
The sputum smear bacilliary load is a fundamental indicator of the level of infectiousness in Drug-Resistant Tuberculosis (DR-TB) patients
The DR-TB patient was defined as a patient with a bacteriologically confirmed result resistant to one of these; rifampicin resistant (RR), MDR, or PreXDR) as confirmed by using either of the Xpert/Mycobacterium tuberculosis (MTB) Rif test or Line Probe Assay (LPA) test or solid/liquid culture media
Socio-demographic and behavioral characteristics Of the total 529 registered bacteriologically confirmed pulmonary DR-TB patients in the study area during the study period, we analyzed the data of 520 patients
Summary
The sputum smear bacilliary load is a fundamental indicator of the level of infectiousness in DR-TB patients. Evidence on DR-TB sputum smear grading and its factors in the study setting is limited. This study was aimed to determine the level of sputum smear grading and associated factors among DR-TB patients in Ethiopia. Tuberculosis (TB) caused by Mycobacterium tuberculosis (MTB) bacteria is ranked as the leading cause of death among infectious diseases in human history [1]. It claimed over a billion lives in the past two centuries [2]. Drug-Resistant Tuberculosis (DR-TB) continues to be one of the challenging global public health threats with more than half a million new cases reported annually in the year 2018 [1, 4]. While in Ethiopia, the estimated DR-TB prevalence was 0.71% among new cases
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