Introduction: Smear positive Tuberculosis is most infectious and carries high morbidity and mortality. The goal line of treatment of smear positive patients is to attain a sputum conversion by two months of potent anti-Tuberculosis. Patients who delay sputum conversion remain potentially infectious, with increased risk of treatment failure, drug resistance and mortality. Little is known about the magnitude of this problem in our setting. This study was designed to determine the prevalence and risk factors of delayed sputum conversion in rural part of northwestern Tanzania.
Methods: This was a retrospective cohort study involving all smear positive Tuberculosis patients treated at Sengerema DDH in 2015. The demographic data, HIV status, sputum smear positivity at Tuberculosis diagnosis and on Tuberculosis treatment were collected and analyzed using STATA 11.
Results: A total of 156 patients were treated for smear positive Tuberculosis during the study period. Males were 97 (62%) with a male to female ratio of 1.64: 1 and a median age of 39 [30-51] years. more than one third, 55 (35.26%) were HIV co infected. The median Tuberculosis bacilli density was 2 (IQR=2-3). A total of 13 (8.33%) had delayed sputum conversion which was strongly associated with a male gender (OR=8.2, p=0.046), age older than 50 years (OR=6.7, p=0.003) and acid fast bacilli density of 3+ (OR=8.1, p=0.008).
Conclusions: Delayed sputum conversion on potent Tuberculosis treatment is common in north western rural Tanzania. These patients can potentially treatment, develop drug resistance and continue spreading Tuberculosis strategies to reduce spreading Tuberculosis. Strategies to reduce the rate of delayed sputum conversion could also reduce these potential unfavorable outcomes.
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