Characteristics and outcomes of tuberculosis patients who fail to smear convert at two months in Bungoma County, 2012‐2015

Abstract

Background: Tuberculosis (TB) remains one of the world’s deadliest communicable diseases. Sputum smear positive patients are infectious for a variable period after start of treatment. Patients’ receiving anti‐TB treatment become non‐infectious within the first two months, assessment of sputum smear conversion is by smear microscopy.

Objective: To determine the characteristics and treatment outcomes of TB patients who fail to smear convert at two months in Bungoma County, 2012‐2015.

Design: Retrospective descriptive study.

Setting: All health facilities managing tuberculosis in Bungoma County.

Subjects: All patients treated for TB, January 2012‐December 2016.

Results: A total of 8393 patients developed TB of which 6998 (83%) had pulmonary TB, of those who had pulmonary TB 3008 (43%) initial smears were positive. After the intensive phase of treatment, 2380 (79%) had converted to smear negative, 141 (5%) were still smear positive and 487 (16%) sputum not
done.

Final outcome showed that those who smear converted at two month had a treatment success rate 2295 (96%) and those who delayed to convert treatment success rate was 108 (77%). Out of those who delayed to smear convert 7 (5%) patients developed drug resistant TB while those whose smear converted none developed drug resistant TB.

Conclusion: The delay in sputum conversion at the end of intensive phase is associated with unfavourable outcome i.e. failure and drug resistant TB.