title: A Retrospective Analysis of Two-Month Sputum Smear Non-Conversion in New Sputum Smear Positive Tuberculosis Patients in the Free State Province, South Africa.
abstract: Little is known about the drivers of two-month sputum smear non-conversion in the South African context. Our study sought to determine these factors in new sputum smear positive tuberculosis (TB) patients in South Africa's Free State Province. A retrospective record review was conducted for all TB patients on treatment between 2003 and 2009. Two-month sputum smear non-conversion was defined by a positive sputum smear result. Data was subjected to univariate, bivariate and regression analyses. Generalized linear regression models were used to estimate the risk for two-month sputum smear non-conversion. Age, pre-treatment sputum smear grading, HIV status and TB disease classification influenced two-month sputum smear non-conversion. Significant associations were thus established between health systems, microbiological, clinical and demographic factors, and two-month sputum smear non-conversion. This study provides program managers with evidence to support the development of more tailored TB care.
authors.affiliation: Centre for Health Systems Research & Development, University of the Free State , Bloemfontein, South Africa.
authors.forename: Nanteza Gladys
authors.initials: NG
authors.lastname: Kigozi
authors.affiliation: Department of Community Health, University of the Free State, Bloemfontein, South Africa; Free State Department of Health, Bloemfontein, South Africa.
authors.forename: Perpetual
authors.initials: P
authors.lastname: Chikobvu
authors.affiliation: Centre for Health Systems Research & Development, University of the Free State , Bloemfontein, South Africa.
authors.forename: James Christoffel
authors.initials: JC
authors.lastname: Heunis
authors.affiliation: Free State Department of Health, Bloemfontein, South Africa.
authors.forename: Sonja
authors.initials: S
authors.lastname: van der Merwe
keywords: Free State Province; South Africa; sputum smear non-conversion; tuberculosis