Affiliation:
1. University of Rwanda
2. Rwanda Biomedical Center
Abstract
Abstract
Background
Non-conversion of sputum smear prolongs the infectivity of pulmonary tuberculosis patients and has been associated with unfavorable tuberculosis (TB) treatment outcomes. Nevertheless, there is a lack of evidence on predictors of sputum smear non-conversion among smear-positive PTB (SPPTB) patients in Rwanda. Therefore, this study aimed to determine the factors associated with sputum smear non-conversion after two months of treatment among SPPTB patients in Rwanda.
Methods
A cross-sectional study was conducted among SPPTB patients registered in the national electronic TB reporting system by all health facilities countrywide (Rwanda) from July 2019 to June 2021. The patients had completed the first two months of anti-TB treatment and with smear results at the end of the second month of treatment. Bivariate and multivariate logistic regression analyses were done to determine the factors associated with sputum smear non-conversion. Odds ratio (OR), 95% confidence interval (CI), and p-value were reported.
Results
This study included 7,211 patients. Of them, 632 (9%) patients had sputum smear non-conversion at the end of the second month of treatment. In multivariate logistic regression analysis, age groups of 20–39 years (AOR = 1.7, 95% CI: 1.04–2.86) and 40–59 years (AOR:2, 95% CI: 1.18–3.3 ), history of first-line TB treatment failure (AOR = 2, 95% CI: 1.1–3.6), follow-up by community health workers (AOR = 1.2, 95% CI: 1.04–1.5), BMI < 18.5 at TB treatment initiation (AOR = 1.5, 95% CI: 1.25–1.8), and living in Northern Province of Rwanda (AOR = 1.4, 95% CI: 1.05-2.0), were found significantly associated with sputum smear non-conversion after two months of treatment.
Conclusion
Sputum smear non-conversion among SPPTB patients remains low in Rwanda compared to countries of similar health care setting. Nevertheless, as the WHO considers sputum conversion as a useful indicator in monitoring the performance of TB control programs, rigorous follow-up of patients with identified risk factors for non-conversion is recommended.
Publisher
Research Square Platform LLC
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