Arsalan Ahmad Salam, Sana Rehman, Muhammad Kashif Munir, Rizwan Iqbal, Muhammad Aasim, Saqib Saeed.
Factors affecting sputum smear conversion time in newly diagnosed pulmonary tuberculosis patients.
Pak J Med Res Jan ;55(1):3-6.

Background: Patients having tuberculosis are registered in the TB DOTS program for their treatment. During the treatment sputum samples are sent periodically to the laboratory to check treatment efficacy. Usually after two months of treatment sputum smear becomes negative but presence of multiple cavities in the lung, bacillary load, diabetes mellitus and tobacco smoking, slows the sputum smear conversion time. Objectives: To determine the factors affecting sputum smear conversion time in newly diagnosed pulmonary tuberculosis patients. Study design, settings and duration: This cross sectional, analytical study was done by Pakistan Medical Research Council, TB Research Centre in collaboration with Institute of TB and Chest Medicine King Edward Medical University/Mayo Hospital, Lahore from April 2013 to March, 2014 Patients and Methods: All newly diagnosed pulmonary tuberculosis patients who were registered and given treatment by the DOTS program were included in the study. All patients underwent sputum smear microscopy along with Complete Blood Count and ESR at the time of enrollment. The patients were followed for next 6 months while on treatment. Sputum samples were tested at 2nd and 6th month to check the sputum conversion rate and indirectly to see the efficacy/compliance to treatment. Results: A total of 400 patients were enrolled with slightly more males (52%) as compared to females (48%). Smear became negative within two months of starting treatment in 85.7% patients while in 14.2% it remained positive at 2nd and 6thmonths of therapy. There were more females (10.7%) whose sputum smear did not became negative as compared to males (3.5%). Predominant factors affecting sputum smear conversion were low resistance, raised initial bacillary load, decreased hemoglobin level, and long duration of symptoms at the time of diagnosis. Conclusion: Factors like low resistance, high initial bacillary load and decreased hemoglobin levels affect the sputum smear conversion and should be addressed while assessing efficacy of anti-tuberculosis treatment. Key words: Tuberculosis, anti tuberculosis treatment, Ziehl Neelsen stain, Acid Fast Bacilli.

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