Document Detail


Non conversion of sputum smears in new smear positive pulmonary tuberculosis patients in Yaound?, Cameroon.
MedLine Citation:
PMID:  20084990     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To identify clinical, radiological and microbiological factors associated with the non conversion of sputum smears in new smear positive cases of pulmonary tuberculosis after two months of treatment and to evaluate the influence of non-smear conversion on treatment outcomes. DESIGN: A prospective cohort study. SETTING: Tuberculosis centre of H?pital Jamot in Yaound?- Cameroon from April 2006 to September 2007. SUBJECTS: A total of 413 patients were studied. MAIN OUTCOME MEASURES: Sputum smear status at two months of treatment, favourable treatment outcome (cured, treatment completed), unfavourable treatment outcome (death, treatment failure, default from treatment) and transferred out. RESULTS: A total of 413 patients were studied; There were 234 (56.8%) males and 178 (43.2%) females with a mean age of 33 years (range 9.80 years). Sputum smears did not convert in 55 (13.4%) patients at the end of two months of treatment. Logistic regression analysis showed that age above or equal to 40 years (OR=2.716, 95% CI:1.412-5.223, p=0.003), and a bacillary load of 3+ on pre-treatment sputum smears (OR=1.955; 95% CI: 1.039-3.68, p=0.037) were significantly associated with non conversion of sputum smears at the end of two months of treatment. Persistent positive smears at the end of two months of treatment were significantly associated with unfavourable treatment outcomes (p=0.025) especially default during the course of treatment. CONCLUSION: In Yaound?, Cameroon, non conversion of positive sputum smears in new patients with pulmonary tuberculosis at the end of two months of treatment is associated with an unfavourable outcome particularly defaulting later in the course of treatment. Non conversion of sputum smears at two months of treatment is significantly associated with age above or equal to 40 years and the presence of numerous bacilli (3+) on pre-treatment sputum smears. Patients with these factors who do not smear convert after two months of treatment should be given a fully supervised treatment for the entire duration of therapy so as to prevent in particular treatment default.
Authors:
C Kuaban; R Bame; L Mouangue; S Djella; C Yomgni
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  East African medical journal     Volume:  86     ISSN:  0012-835X     ISO Abbreviation:  East Afr Med J     Publication Date:  2009 May 
Date Detail:
Created Date:  2010-01-20     Completed Date:  2010-03-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372766     Medline TA:  East Afr Med J     Country:  Kenya    
Other Details:
Languages:  eng     Pagination:  219-25     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaound?, Yaound?, Cameroon.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Antibiotics, Antitubercular / therapeutic use
Antitubercular Agents / therapeutic use
Cameroon
Child
Confidence Intervals
Ethambutol / therapeutic use
Female
Humans
Isoniazid / therapeutic use
Logistic Models
Male
Middle Aged
Mycobacterium tuberculosis / isolation & purification*
Odds Ratio
Prospective Studies
Pyrazinamide / therapeutic use
Rifampin / therapeutic use
Sputum / microbiology*
Time Factors
Treatment Outcome
Tuberculosis, Pulmonary / diagnosis*,  drug therapy,  microbiology
Young Adult
Chemical
Reg. No./Substance:
0/Antibiotics, Antitubercular; 0/Antitubercular Agents; 13292-46-1/Rifampin; 54-85-3/Isoniazid; 74-55-5/Ethambutol; 98-96-4/Pyrazinamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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