Determinant Factors and Time To Sputum Smear And Culture Conversion Among Multidrug Resistant Tuberculosis Patients in St. Peter’s Tuberculosis Specialized Hospital, Addis Ababa

Abstract

BACKGROUND: MDR-TB is increasing and now it has become a big threat to the National tuberculosis program. The Ethiopian government has identified MDR-TB as one of the priority public health problems and it is committed to initiate comprehensive treatment of MDR cases in the country. With the approval of the Green Light committee, it has started the treatment of MDR-TB since February 2009 by selecting a pilot project which is at the St. Peter’s TB Specialized hospital in Addis Ababa and rapid expansion to the regions is foreseen and preparation is underway. In this study we will assess the time to sputum smear and culture conversion. OBJECTIVE: To assess the time to sputum smear and culture conversion and determinant factors associated with conversion among MDR-TB patients admitted to St. Peter’s TB-specialized hospital. METHOD: Retrospective Cross sectional study among MDR-TB patients admitted to St. Peter’s TBspecialized hospital starting from February 2009. A total of 149 patients who fulfill the inclusion criteria are included in the study. Data were collected using compilation form from the available medical records, treatment charts, bacteriologic reports and chest x-ray results. RESULTS: Sputum smear conversion was found to be 107(71.81%), 133(89.26%) in the first and second month respectively. Age was found to be significantly associated with sputum conversion P: 0.032, and 0.027. The Culture conversion in the second month revealed 73(48.99%). HIV status, presence of pleural effusion were factors found to be associated with culture conversion at 2 months, HIV positives and those with pleural effusion being late converters. Culture conversion in the third month revealed 123(82.55%) and here those age group ≤ 24 and HIV negatives were found to covert early CONCLUSION AND RECOMMENDATION This study revealed that with strict in-patient treatment, of nearly 80% of sputum smear and culture conversion could be achieved. This can reduce the length of in-patient stay (which at present is extending up to six months) and more patients can get chance for MDR-TB treatment. The younger age group ≤24 years, HIV negatives and those with no pleural effusion are the early converters therefore minimizing the length of stay in the hospital to 3 months can be considered on these patients.