Sputum conversion among new smear positive pulmonary tuberculosis patients attending tb/dots clinics in Anambra state, Nigeria

Abstract

Objectives: Sputum conversion among smear-positive pulmonary tuberculosis patients was studied and its predictors evaluated in Anambra State Nigeria.The objectives were to estimate sputum conversion rates the end of 2 months following intensive treatment and also at 5 th month. Method: Nigeria National Tuberculosis Guidelines for diagnosis of pulmonary tuberculosis was used and Acid Fast Bacilli (AFB) were determined by Ziehl-Neelsen technique. All smears with ≥ 1 AFB/100 hpf were considered positive. Results: A total of 183 pulmonary tuberculosis patients participated. Sputum smear conversion was observed in 159 (86.9%) patients at the end of the 2 nd month. Conversion rates were 96.2% and 97.8% at end of 3 rd and 5 th months respectively. Sputum conversion rates was similar in males and females (P>0.05) but age ≥ 45years was significantly (P<0.05) associated with delay in conversion. Patients with pre-treatment AFB smear grade of 3+ had the least conversion rate than the lower grades (P<0.05). At the end of 5 th month, 4 (2.2%) patients failed to convert. Conclusion: Sputum smear conversion rates at end of 2 nd , 3 rd and 5 th months was satisfactory. Older age and initial high bacillary load were associated with delayed smear conversion.