Predictors of sputum culture conversion time among MDR/RR TB patients on treatment in a low-income setting

Abstract

Objective This study aimed to assess the time to first culture conversion and its predictors among MDR/RR-TB cases enrolled in Dilchora Hospital. Method A retrospective cohort study was conducted among MDR/RR TB cases enrolled between January 2014 and December 2018. SPSS version 26 was used for analysis. Reports are presented using percentages and frequency. Independent predictors of time-to-culture conversion were identified using multivariate Cox proportional hazard regression. Adjusted and crude hazard ratio with 95% CI was used. P-value< 0.05 declared statistical significance. Result A total of 145 MDR/RR TB cases were included. The median time to culture conversion was at 2 months. Higher baseline hemoglobin [AHR:1.101(1.02–1.19)] and having a non-cavitary lesion on chest x-ray[AHR:1.803(1.15–2.83)] predicted a higher likelihood of early culture conversion. Resistance to at least one first-line anti-TB drug in addition to rifampicin was associated with a lower hazard of early culture conversion as compared to only rifampicin resistance[AHR: 0.577(0.37–0.91)]. Conclusion & recommendation A baseline hemoglobin level, chest x-ray finding of cavitation and resistance to rifampicin, and at least one additional drug predicted the time to culture conversion. A closer treatment monitoring and follow-up should be emphasized for those presenting with lower baseline hemoglobin, more drug resistance, and cavitation on chest x-ray.