Prevalence and associated factors of delayed sputum smear conversion in patients treated for smear positive pulmonary tuberculosis: A retrospective follow up study in Sabah, Malaysia

Khor, Linghui Amanda and A. Wahid, Ulfa Nur Izzati and Ling, Lee Lee and Liansim, Sarah Michael S. and Oon, Jush'n and Balakrishnan, Mahendran Naidu and Ng, Wei Leik and Cheong, Ai Theng (2023) Prevalence and associated factors of delayed sputum smear conversion in patients treated for smear positive pulmonary tuberculosis: A retrospective follow up study in Sabah, Malaysia. PLoS ONE, 18 (3). ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0282733.

Full text not available from this repository.

Abstract

IntroductionTuberculosis remains a major health problem globally and in Malaysia, particularly in the state of Sabah. Delayed sputum conversion is associated with treatment failure, drug-resistant tuberculosis and mortality. We aimed to determine the prevalence of delayed sputum conversion among smear positive pulmonary tuberculosis (PTB) patients and its associated factors in Sabah, Malaysia. MethodsA retrospective follow up study on all patients newly diagnosed with smear positive pulmonary tuberculosis from 2017 to 2019 was conducted at three government health clinics in Sabah, utilizing data from a national electronic tuberculosis database and medical records. Descriptive statistics and binary logistic regression were applied for data analysis. The outcome of the study was the sputum conversion status at the end of the two-month intensive treatment phase with either successful conversion to smear negative or non-conversion. Results374 patients were included in the analysis. Our patients were generally younger than 60 years old with no medical illness and varying proportions of tuberculosis severity as judged by radiographic appearance and sputum bacillary load upon diagnosis. Foreigners constituted 27.8% of our sample. 8.8% (confidence interval: 6.2-12.2) did not convert to smear negative at the end of the intensive phase. Binary logistic regression showed that older patients >= 60 years old (adjusted odds ratio, AOR = 4.303), foreigners (AOR = 3.184) and patients with higher sputum bacillary load at diagnosis 2+ (AOR = 5.061) and 3+ (AOR = 4.992)] were more likely to have delayed sputum smear conversion. ConclusionThe prevalence of delayed sputum conversion in our study was considerably low at 8.8% with age >= 60 years old, foreigners and higher pre-treatment sputum bacillary load associated with delayed conversion. Healthcare providers should take note of these factors and ensure the patients receive proper follow up treatment.

Item Type: Article
Funders: None
Uncontrolled Keywords: Bacillus; Firmicutes; Follow-up studies; Humans; Lacticaseibacillus casei; Malaysia; Middle aged; Prevalence; Retrospective Studies; Sputum; Tuberculosis, Pulmonary
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC306-320.5 Tuberculosis
Divisions: Faculty of Medicine > Primary Care Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 01 Dec 2023 04:38
Last Modified: 01 Dec 2023 08:23
URI: http://eprints.um.edu.my/id/eprint/38460

Actions (login required)

View Item View Item