Time to sputum culture conversion and treatment outcome among the first cohort of multidrug resistant tuberculosis patients in a high burden country.

Background: Sputum conversion considered the most important interim indicator of the efficacy of anti-tuberculosis treatment was assessed at varying time points among the first cohort of multidrug resistant tuberculosis (MDR-TB) patients in a National TB Control Programme.

Methods: A retrospective study was conducted for the period between 2010 and 2013, at the premiere MDR-TB treatment center in Nigeria. Genexpert, culture and drug susceptibility tests were carried out. Total duration of treatment was 20 months.

Results: A total of 115 patients were studied consisting of 76 (66.1%) males and 39 (33.9%) females with ages ranging between 15 and 65 years. Median time to sputum conversion was 2.06 months (95% confident interval [CI] = 1.82, 2.30). At the end of the first month, 43 (37.4%) patients sputum converted, increasing to 104 (90.4%) at the end of three months. There was no significant interaction with Human Immunodeficiency Virus (HIV) status. Overall treatment success was 69.4%. The default rate was 8.7% (10/115) and 25 (21.7%) deaths were recorded.

Conclusion: The treatment success rate in the study was high with most of cases with or without HIV infection, achieving sputum culture conversion within 2 months of commencing treatment. Expansion of MDR-TB treatment services is necessary to reduce the death rate.