AUTHOR=Alzarea Abdulaziz Ibrahim , Saifullah Amna , Khan Yusra Habib , Alanazi Adullah Salah , Alatawi Ahmed D. , Algarni Majed Ahmed , Almalki Ziyad Saeed , Alahmari Abdullah K. , Alhassan Hassan H. , Mallhi Tauqeer Hussain 

TITLE=Evaluation of time to sputum smear conversion and its association with treatment outcomes among drug-resistant tuberculosis patients: a retrospective record-reviewing study

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1370344

DOI=10.3389/fphar.2024.1370344

ISSN=1663-9812

ABSTRACT=This study examined the time to sputum smear and culture conversion, and determinants of conversion as well as variables associated with treatment outcomes among drug resistant pulmonary tuberculosis cases. The electronic database and the written medical records of patients were utilized to assess the sociodemographic, clinical, microbiological, treatment characteristics, and outcomes of study participants. Of 736 patients with pulmonary tuberculosis (mean age=36.5±16.5 years, males=53.4%, weight=47.76±11.97 kg). The median time period to sputum smear conversion and sputum culture conversion was a month. The first month culture conversion (p<0.001, aOR= 5.817, 95% CI=3.703-9.138) was the determinant of sputum smear conversion and receiver operating curve analysis with AUC=0.881, 95% CI=0.855-0.907, p<0.001) showed a high level of predictive ability for regression model for the initial sputum smear conversion. However, the first month sputum conversion (p<0.001, aOR=7.446, 95% CI=4.869-11.388) was attributed to sputum culture conversion and the model have shown the excellent predictive ability for regression with ROC curve analysis demonstrating AUC=0.862, (95% CI=0.835-0.889, p<0.001). A total of 63.2% patients have showed favorable treatment outcomes with 63.1% of cases with treatment cured status. The previous use of SLD, history of smoking, duration of illness  1year, Extensively drug resistant tuberculosis and first month sputum conversion were the variables attributed to favorable treatment outcomes, observed in drug resistant pulmonary tuberculosis cases. ROC curve analysis with AUC=0.902, (95% CI=0.877-0.927, p<0.001) have shown an outstanding ability for regression model prediction for the variables influencing treatment outcomes. Within two months of treatment, most patients had converted their sputum cultures and sputum smears. Determinants of early sputum smear and sputum culture conversion, as well as favorable treatment outcomes were identified. These factors should be considered during designing and implementation of effective strategies for drug resistant tuberculosis control programs.