Introduction: Smear positive TB carries high morbidity and mortality. The TB treatment aims at sputum conversion by two months of antituberculous. Patients who delay sputum conversion remain potentially infectious, with risk of treatment failure, drug resistance, and mortality. Little is known about the magnitude of this problem in our setting. This study was designed to determine the prevalence and risk factors of delayed sputum conversion in northwestern rural part of Tanzania.
Methods: This was a retrospective cohort study involving smear positive TB patients at Sengerema DDH in 2015. Demographic data, HIV status, and sputum results at TB diagnosis and on TB treatment were collected and analyzed using STATA 11.
Results: In total, 156 patients were studied. Males were 97 (62%); the median age was 39 [30-51] years. Fifty-five (35.3%) patients were HIV coinfected and 13 (8.3%) patients had delayed sputum conversion which was strongly associated with male gender (OR = 8.2, = 0.046), age >50 years (OR = 6.7, = 0.003), and AFB 3+ (OR = 8.1, = 0.008).
Conclusions: Delayed sputum conversion is prevalent in this study. These patients can potentially fail on treatment, develop drug resistance, and continue spreading TB. Strategies to reduce the rate of delayed sputum conversion could also reduce these potential unfavorable outcomes.
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http://dx.doi.org/10.1155/2017/5352906 | DOI Listing |
Clin Infect Dis
January 2025
EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
Background: Higher than standard doses of rifampicin could improve the treatment outcome of drug-susceptible tuberculosis without compromising the safety of patients.
Methods: We performed a systematic review of prospective clinical studies including adults with pulmonary and extrapulmonary TB receiving rifampicin doses above 10mg/kg/day. We extracted the data on overall adverse events (AE), hepatic AE, sputum culture conversion (SCC) at week 8, recurrence, mortality, and pharmacokinetics.
Antibiotics (Basel)
December 2024
Pharmacogenetic and Precision Medicine Laboratory, Pharmaceutical Education and Research Centre, Riga Stradins University, Konsula Street 21, LV1007 Riga, Latvia.
Serum C-reactive protein (CRP) levels vary depending on radiological and bacteriological findings at the time of tuberculosis (TB) diagnosis. However, the utility of this biomarker in monitoring response to anti-TB treatment and identifying patients at risk of treatment failure is not well established. This study evaluated the impact of patients' baseline characteristics and anti-TB drug plasma exposure on the early reduction in serum CRP levels and its relationship with treatment response.
View Article and Find Full Text PDFInt J Tuberc Lung Dis
January 2025
Department of Pharmacology and Therapeutics, Makerere College of Health Sciences, Kampala, Uganda.
Cureus
November 2024
Pulmonology, Unidade Local de Saúde Amadora/Sintra, Amadora, PRT.
Introduction The prevalence of nontuberculous mycobacteria (NTM) is higher in patients with structural lung disease and in immunocompromised patients. Lung involvement is the most common. The complex corresponds to the most identified agent.
View Article and Find Full Text PDFJ Infect
December 2024
German Center for Infection Research (DZIF), Partner site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany; Division of Clinical Infectious Diseases, Research Center Borstel, Parkallee 1-40, 23845 Borstel, Germany.
Objectives: Early detection of treatment failure is essential to improve the management of drug-resistant tuberculosis (DR-TB). We evaluated the molecular bacterial load assay (MBLA) in comparison to standard diagnostic tests for monitoring therapy of patients affected by drug-resistant TB.
Methods: The performance of MBLA in tracking treatment response in a prospective cohort of patients with pulmonary MDR/RR- and pre-XDR/XDR-TB was compared with mycobacterial culture, mycobacterial DNA detection using GeneXpert (Xpert) and microscopy detection of sputum acid-fast-bacilli.
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