Factors predicting persistent sputum smear positivity among pulmonary tuberculosis patients 2 months after treatment.
METHODS
Studies have shown that adverse outcomes are more likely in patients showing persistent sputum positivity at the end of 2 months of anti-tuberculosis treatment.


OBJECTIVE
To identify simple clinical, microbiological or radiological factors associated with persistent sputum positivity under national programme conditions.


METHODS
Sputum smear-positive pulmonary tuberculosis patients admitted in 2 consecutive years to a referral hospital, and who received standard short-course chemotherapy under direct observation, were reviewed retrospectively. Factors associated with persistent sputum smear positivity were analysed.


RESULTS
A total of 514 patients were available for review. Logistic regression analysis showed that age groups 41-60 years and more than 60 years, numerous bacilli on initial sputum smear examination, and presence of multiple cavitary diseases were significant factors associated with persistent sputum positivity at the end of 2 months of treatment (P < 0.0001).


CONCLUSIONS
Identification of high risk factors associated with persistent sputum positivity, such as specific age groups, numerous bacilli on initial sputum smear examination, and presence of multiple cavitary diseases, may be helpful in stratifying the patients according to the risk of adverse outcome, thus allowing greater efficiency in resource utilisation.
Singla
R
R
Sahary Hospital, Department of Tuberculosis and Chest Diseases, Riyadh, Saudi Arabia. drrupak@hotmail.com
Osman
M M
MM
Khan
N
N
Al-Sharif
N
N
Al-Sayegh
M O
MO
Shaikh
M A
MA
D000328:Adult; D023801:Directly Observed Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy*