Risk factors for sputum smear conversion failure at the end of intensive phase of

Pulmonary Tuberculosis treatment

Bayu Rizky Riannisa1, Ginanjar Putriyani1, Abdul Kamil1, Sofia Imaculata1,
Susan McAllister2, Raspati Cundarani1, Bachti Alisjahbana1
1. TB-HIV Research Center, Faculty of Medicine, Universitas Padjadjaran, Bandung
2. Center for International Health, Department of Preventive and Social Medicine,
University of Otago, Dunedin, New Zealand

Background
In 2015, Indonesia wais the second country with highest country with pulmonary
Tuberculosis (TB) infection in the world in 2015. The National Tuberculosis Program
aims to reach at the conversion rate at least 80% conversion rate (percentage of patients
with positive sputum smear that convert to negative result) at the end of intensive phase
treatment. Conversion rate is a percentage of patients with positive sputum smear result
that convert to negative result. The longer a Ppatients who take longer to convert pose a
greater risk of , the longer transmission of Mycobacterium tuberculosis transmission
occurs in the community. This study aimed to identify risk factors for sputum smear
conversion failure at the end of intensive phase treatment.
Methods
As part of the TANDEM program (www.tandem-fp7.eu), a cross- sectional study was
conducted between April 2014 December 2015. TB pPatients were recruited from the
community health centers in Bandung and followed up for two months. A questionnaire
was asked to the Ppatients were intervieweds to collect information about risk factors.
Sputum smear examination was done during at recruitment and after two months. Chi-
Square test was used to test for significance.
Results
A total of 198 patients were recruited of whom, 59.1% were males and mean age was
44.645 (SD 13.1). Of those, 76Seventy-six (38.4%) patients (38.4%) failed to convert.
Factors associated with conversion failure by Chi-Square test arewere age (p- Commented [SM1]: Is this older age??

value=0.021), and higher bacterial load during at baseline (p-value=0.003). Six other
factors: education (p-value=0.17), diabetes history (p-value=0.33), tb TB history (p-
value=0.70), number of people in household (p-value=0.21), BMI (p-value=0.22) and
coughing up blood (p-value=0.38) were not significantly associated with conversion
failure.
Conclusion
Sputum smear conversion failure in this study was Aalmost 40% of the patients had
sputum smear conversion failure at the end of intensive treatment phase. Age and Commented [SM2]: Older??

higher bacterial load were associated with sputum smear conversion failure. Commented [SM3]: Can you say anything more about
what this means?? Ie. Is the 40% higher than you would
Keyword : risk factors, sputum smear conversion, tuberculosis expect? What are the implications of age and bacterial load
being risk factors?