Factors influencing delay in sputum conversion in smear-positive pulmonary tuberculosis patients in primary care in Kuala Lipis Pahang

https://doi.org/10.53730/ijhs.v6nS7.13077

Authors

  • Narasimman Baskaran Faculty of pharmacy, cyberjaya university college of medical sciences, 63000 cyberjaya, selangor, Malaysia, Pejabat kesihatan kuala lipis,27650 kuala lipis, pahang, malaysia
  • Leong Siew Lian School of pharmacy, monash university, 47500, subang, selangor, malaysia
  • Nurul Ashikin Jamludin Faculty of pharmacy, cyberjaya university college of medical sciences, 63000 cyberjaya, selangor, malaysia

Keywords:

sputum conversion, pulmonary tuberculosis, factor influencing

Abstract

objective. This study was conducted to investigate factors associated with delay in sputum conversion at first and second months during pulmonary tuberculosis treatment.           Methods. A retrospective cross-sectional study was conducted in multicentre at primary care clinics in the district of kuala lipis pahang among newly diagnosed pulmonary tuberculosis patients in 2015-2019. Sociodemographic, clinical, and treatment-related data on patients' medical charts were collected using a standardized data collection form. Results. This study enrolled 147 participants with a mean age of 47.34 years. The sputum conversion rate at the end of the second month was 78.9%. Multiple logistic regression analysis was used to predict the factors that influence the delay in sputum conversion. The results found a statistically significant association (p <0.05) to those patients with diabetes mellitus (aor 2.51) during the 1st and 2nd months (aor 1.52), smokers (aor 2.66) during the 1st and 2nd months (aor 4.56), being underweight (aor 4.56) at 1st month and (aor 3.34) at 2nd month and hiv positive status during the 1st month (aor 1.18) and 2nd month (aor 2.406) were found to be predicted factors that influencing with delayed sputum smear conversion at 1st and 2nd month during pulmonary tuberculosis treatment. 

Downloads

Download data is not yet available.

References

World Health Organization. Tuberculosis country profiles: Malaysia Geneva: World Health Organization; 2020.

https://www.who.int/tb/country/data/profiles/en. Accessed 3rd April 2020.

Management of Tuberculosis Malaysia 3rd edition

Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination. Core Curriculum on Tuberculosis: What the Clinician Should Know. 4th edition (2000). Updated August 2003.

Management: Directly Observed Therapy, New York City Department of Health, 2001.

K. E. Dooley and R. E. Chaisson 2009, "Tuberculosis and diabetes mellitus: convergence of two epidemics," The Lancet Infectious Diseases, vol.9, no.12, pp.737–746,2009

Suyono, Slamet. 2004. Buku Ajar Ilmu Penyakit Dalam. Edisi ke-3. Jakarta: Fakultas Kedokteran Universitas Indonesia

Prayitno, A., Suyono, B., Suryanto, E., & Suparto, R. (2006). Tes Diagnostik Sputum pada Penderita Tuberkulosis Paru. BioSMART, 7(1):14-15

Doenges, Marilynn E. 2005. Nursing Diagnosis Manual. Philadelphia: Davis Company Francis, Caia. 2011. Pera

Mansjoer, A (2000) Kapita Selekta Kedokteran jilid I. Jakarta: Media Aesculapius.

K. E. Dooley and R. E. Chaisson, "Tuberculosis and diabetes mellitus: convergence of two epidemics," The Lancet Infectious Diseases,vol.9,no.12,pp.737–746,2009

Daniel TM. The origins and precolonial epidemiology of tuberculosis in the Americas: can we figure them out? Int J Tuberc Lung Dis. 2000 May;4(5):395-400. PMID: 10815731.

Ait-Khalid N, Alarcon E, Armengol R, Bissell K, Boillot F, Caminero JA, et al. management of tuberculosis: a guide to the essentials of good practice. Sixth ed. Paris,France: International Union Against Tuberculosis and Lung Disease; 2010.

Treatment of tuberculosis guideliness. Forth ed: World Health Organization; 2010. p.24-5.

Rieder HL. Epidemiologic Basis of Tuberculosis Control. First ed. Paris: International Union Against Tuberculosis and Lung Disease; 1999.

Ayele WY, Neill SD, Zinsstag J, Weiss MG, Pavlik I. Bovine tuberculosis: an old disease but a new threat to Africa. Int J Tuberc Lung Dis. 2004;8(8):924-37.

APIC Indiana - Extrapulmonary TB. https://apicin.org/Extrapulmonary_TB

R. F. Mary Jones, Cambridge International AS and A level Biology Coursebook Third Edition (pp. 208-211). United Kingdom: Cambridge University Press 2013

Payam Nahid, Susan E. Dorman, Narges Alipanah, Pennan M. Barry, Jan L. Brozek, Adithya Cattamanchi, Lelia H. Chaisson, Richard E. Chaisson, Charles L. Daley, Malgosia Grzemska, Julie M. Higashi, Christine S. Ho, Philip C. Hopewell, Salmaan A. Keshavjee, Christian Lienhardt, Richard Menzies, Cynthia Merrifield, Masahiro Narita, Rick O'Brien, Charles A. Peloquin, Ann Raftery, Jussi Saukkonen, H. Simon Schaaf, Giovanni Sotgiu, Jeffrey R. Starke, Giovanni Battista Migliori, Andrew Vernon, Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis, Clinical Infectious Diseases, Volume 63, Issue 7, 1st October 2016, Pages e147–e195, https://doi.org/10.1093/cid/ciw376

K. Gholami, E. Kamali, M. Hajiabdolbaghi, and G. Shalviri. Evaluation of anti-tuberculosis induced adverse reactions in hospitalized patients. pharmacy practice, 2006; 4(3): 134– 138.

Lienhardt C, Fielding K, Sillah JS, Bah B, Gustafson P, Warndorff D, Palayew M, Lisse I, Donkor S, Diallo S, Manneh K, Adegbola R, Aaby P, Bah-Sow O, Bennett S, McAdam K. Investigation of the risk factors for tuberculosis: a casecontrol study in three countries in West Africa. Internet J Epidemiol., 2005; 34: 914-23. 8.

M. Sharma, KVyas, J. et. al. (2016 14th November, Updated). Sputum stain for mycobacteria. MedlinePlus Medical Encyclopedia.

Feng-Zeng Z, Levy M H, Sumin W. Sputum microscopy results at two and three months predict outcome of tuberculosis treatment. Int J Tuberc LungDis. 1997; 1:570–572.

STAG-TBWHO. https://www.who.int/tb/advisory_bodies/stag_tb_report_2015.pdf

Agarwal R, Malhotra P, Awasthi A, Kakkar N, Gupta D (2005). "Tuberculous dilated cardiomyopathy: an under-recognized entity?". BMC Infect Dis 5 (1): 29. doi:10.1186/1471-2334-5-29. PMID 15857515

Greta Musteikienė, Skaidrius Miliauskas, Jurgita Zaveckienė, Marius Žemaitis, Astra Vitkauskienė, Factors associated with sputum culture conversion in patients with Pulmonary Tuberculosis, Medicine, Volume 53, Issue 6,2017

Cole E, Cook C (1998). "Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies." Am J Infect Control 26 (4): 453–64. doi:10.1016/S0196-6553(98)70046-X. PMID 9721404

Gutierrez MC, Brisse S, Brosch R, et al. (September 2005). "Ancient origin and gene mosaicism of the progenitor of Mycobacterium tuberculosis." PLoS Pathog. 1 (1): e5. doi:10.1371/journal.pp.0010005. PMID 16201017. PMC:1238740.

Djouma FN, Noubom M, Ateudjieu J, Donfack H. Delay in sputum smear conversion and outcomes of smear-positive tuberculosis patients: a retrospective cohort study in Bafoussam, Cameroon. BMC Infect Dis. 2015 21st March; 15:139. doi: 10.1186/s12879-015-0876-1. PMID: 25884844; PMCID: PMC4381415.

Fisher D, Wilder-Smith A. The global community needs to ramp up the response to contain COVID-19 swiftly. Lancet. 2020;395(10230):1109-10.

Lin HH, Ezzati M, Chang HY, Murray M. Association between tobacco smoking and active Tuberculosis in Taiwan prospective cohort study. Am J Respir Crit Care Med. 2009;180(5):475–480. DOI: 10.1164/ccm.200904-0549OC

A.T. Abal, B. Jayakrishnan, S. Parker, A. El Shamy, E. Abahussain, P.N. Sharma, Effect of cigarette smoking on sputum smear conversion in adults with active pulmonary Tuberculosis, Respiratory Medicine, Volume 99, Issue 4,2005,

Kaufmann S (2002). "Protection against tuberculosis: cytokines, T cells, and macrophages." Ann Rheum Dis 61 Suppl 2: ii54–8. PMID 12379623.

OECD/WHO. (2016). Tuberculosis. Health at a Glance: Asia/Pacific 2016: Measuring Progress towards Universal HealthCoverage, OECD Publishing, Paris. Retrieved from http://dx.doi.org/10.1787/health glance ap2016

Diktanas, Saulius et al. "Factors Associated with Persistent Sputum Positivity at the End of the Second Month of Tuberculosis Treatment in Lithuania." Tuberculosis and respiratory diseases vol. 81,3 (2018): 233-240. doi:10.4046/trd.2017.0096

Palhares Campolina J, Gesteira Coelho S, Belli AL, et al. Effects of a blend of essential oils in milk replacer on performance, rumen fermentation, blood parameters, and health scores of dairy heifers. PLoS One. 2021;16(3): e0231068. Published 2021 11th March.doi: 10.1371/journal.pone.0231068

Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ 1994; 309:901-911.

Arcavi L, Benowitz NL. Cigarette smoking and infection. Arch Intern Med 2004; 164:2206-2216.

Gajalakshmi V, Peto R, Kanaka TS, Jha P. Smoking and mortality from tuberculosis and other diseases in India: retrospective study of 43000 adult male deaths and 35000 controls. Lancet 2003; 362:507-515.

Santha T. How can the progress of treatment be monitored? In: TOMAN'S tuberculosis cases detection, treatment, and monitoring WHO Geneva, 2nd ed. 2004;250-5.

Singla, R., Osman, M. M., Khan, N., Al-Sharif, N., Al-Seyigh, M. O. &Sheik, M. A. (2003). Factors predicting persistent sputum smear positivity among pulmonary tuberculosis patients, 2 months after treatment. International Journal of Tuberculosis and Lung Disease, 7(1), 58-64

Kuaban, C., Bame, R., Mouangue, L. &Djella, S. (2009). Non conversion of positive smears in new smear positive pulmonary tuberculosis patients in Yaounde, Cameroon. East African medical Journal, 86(5), 219-225.

Calderwood CJ, Wilson JP, Fielding KL, Harris RC, Karat AS, Mansukhani R, Falconer J, Bergstrom M, Johnson SM, McCreesh N, Monk EJM, Odayar J, Scott PJ, Stokes SA, Theodorou H, Moore DAJ. Dynamics of sputum conversion during effective tuberculosis treatment: A systematic review and meta-analysis. PLoS Med. 2021 Apr 26;18(4): e1003566. doi: 10.1371/journal.pmed.1003566. PMID: 33901173; PMCID: PMC8109831.

Shariff NM, Safian N. Diabetes mellitus and its influence on sputum smear positivity at the 2nd month of treatment among pulmonary tuberculosis patients in Kuala Lumpur, Malaysia: A case control study. Int J Mycobacteriol. 2015 Dec;4(4):323-9. doi: 10.1016/j.ijmyco.2015.09.003. Epub 2015 Oct 1. PMID: 26964816.

Rekha B, Swaminathan S. Childhood tuberculosis - global epidemiology and the impact of HIV. Paediatr Respir Rev. 2007 Jun;8(2):99-106. doi: 10.1016/j.prrv.2007.04.010. Epub 2007 Jun 4. PMID: 17574153.

Soh, Avril & Chee, Cynthia & Wang, Yee-Tang & Yuan, Jian-Min & Koh, Woon-Puay. (2017). Alcohol drinking and cigarette smoking in relation to risk of active tuberculosis: Prospective cohort study. BMJ Open Respiratory Research. 4. e000247. 10.1136/bmjresp-2017-000247.

Soh AZ, Chee CBE, Wang Y, et al Alcohol drinking and cigarette smoking in relation to risk of active tuberculosis: prospective cohort study BMJ Open Respiratory Research 2017;4: e000247. doi: 10.1136/bmjresp-2017-000247

Published

29-09-2022

How to Cite

Baskaran, N., Lian, L. S., & Jamludin, N. A. (2022). Factors influencing delay in sputum conversion in smear-positive pulmonary tuberculosis patients in primary care in Kuala Lipis Pahang. International Journal of Health Sciences, 6(S7), 4908–4925. https://doi.org/10.53730/ijhs.v6nS7.13077

Issue

Section

Peer Review Articles

Most read articles by the same author(s)