Comparative analysis of sputum conversion failure rates after intensive phase of treatment in new smear-positive cases versus retreatment cases of pulmonary tuberculosis: A prospective analytical study.
- Author:
Wayet Dominador D
;
Suquila Jason T
- Publication Type:Journal Article
- MeSH: Human; Male; Female; Adult; Young Adult; Adolescent; Tuberculosis, Pulmonary-Therapeutics, therapy; Sputum
- From: The Filipino Family Physician 2014;52(1):18-29
- CountryPhilippines
- Language:English
-
Abstract:
INTRODUCTION: Tuberculosis has been a major problem in the Philippines for the past several decades ranking as the 6th (previously 5th) leading cause of mortality and morbidity based on the recent local data. For successful implementation of the Revised National Tuberculosis Control Program, treatment outcomes and factors which influence them need to be assessed on a regular basis. This study was done to find out the sputum conversion failure rate, socio-demographic factors and clinical profiles and comorbidities of new smear positive cases and retreatment cases of pulmonary tuberculosis seen and admitted at the Tuberculosis Center (TBC) of San Lazaro Hospital from January to June 2011.
METHODOLOGY: This is a records-based prospective analytical study design. Information pertaining to new smear-positive cases (or category I) and retreatment cases (or category II) were recorded using case report form.
RESULTS: Of the 131 TB patients, 63.3% were new smear-positive cases or on category I treatment. The sputum conversion failure rates among new case and retreatment PTB patients were 2.41% and 14.58%, respectively. Using chi-square test for independence to determine the association, the sputum conversion failure rates are dependent with the type of TB patient (i.e., new smear-positive case or retreatment case) (X2= 7.004, df= 1, P= 0.008). All clinical and socio-demographic factors were entered in the model for binary logistic regression analysis. Only hemoptysis (P= 0.024) and type of TB patient (P= 0.033) are statistically significantly associated with sputum conversion failure. The odds of having a sputum conversion failure after intensive phase of treatment are 9.8 times (95% Cl: 10349-71.779) among TB patients with hemoptysis upon admission as compared to those TB patients without hemoptysis, and 8.1 times (95%Cl: 1.179-55.423) among TB patients who were admitted for retreatment (due to relapse, return after default, or treatment failure) as compared to those TB patients who were admitted as new smear-positive cases.
CONCLUSION: Sputum conversion rates were generally satisfactory in this study. However, the sputum conversion failure rates among new smear-positive cases and retreatment PTB patients were 2.41% and 14.58%, respectively. Among the rid factors, hemoptysis (OR= 9.8, 95%CL: 1.349-71.779, P= 0.024) and retreatment PTB patients (OR= 8.1, 95%Cl: 1.179-55.423, P=0.033) are statistically significantly associated with sputum conversion failure.