East African Medical Journal

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

Robert S. Magomere, Rose J. Kosgei, Maureen Kamene, David Gathara, Nicholas Kirui, Paul Lodi, John Omondi, Enos Masini, Eunice Omesa


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

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.

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