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Five-Year Assessment of Time of Sputum Smears Conversion and Outcome and Risk Factors of Tuberculosis Patients in Central Iran

Objective. To evaluate risk factors which influence sputum smear conversion, outcome, and trends of conversion of sputum smear during 5 years and compare outcomes in patients with different regimens. Methods. In a retrospective cohort study, all patients with sputum smear positive tuberculosis were...

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Autores principales: Behnaz, Fatemah, Mohammadzadeh, Mahmoud, Mohammadzade, Golnaz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310312/
https://www.ncbi.nlm.nih.gov/pubmed/25653874
http://dx.doi.org/10.1155/2015/609083
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author Behnaz, Fatemah
Mohammadzadeh, Mahmoud
Mohammadzade, Golnaz
author_facet Behnaz, Fatemah
Mohammadzadeh, Mahmoud
Mohammadzade, Golnaz
author_sort Behnaz, Fatemah
collection PubMed
description Objective. To evaluate risk factors which influence sputum smear conversion, outcome, and trends of conversion of sputum smear during 5 years and compare outcomes in patients with different regimens. Methods. In a retrospective cohort study, all patients with sputum smear positive tuberculosis were evaluated for comorbidities and demographic, microbiological, and therapeutic data and outcome. Smear examinations were performed at the beginning, at 2 months for CAT I, at 3 months for CAT II, at the end of second month of maintenance phase, and at the end of treatment. Results. This study enrolled 211 sputum smear positive patients, but 189 patients who completed the intensive phase of treatment were evaluated. Sputum smear of 158 patients converted at the end of intensive phase (83.6). Univariate analysis indicated that the risk of a persistent positive smear at the end of intensive phase was greater in diabetic patients ((odds 4.038, 95% CI 1.123–14.516) P = 0.033), and also a 3+bacillary load had risk of 2.933-fold ((95% CI 1.278–6.732) P = 0.011). Overall rate of unfavorable outcome was 20.9%. Factors associated with unfavorable outcome were age (P value 0.000), male gender (P value 0.027), diabetes (P value 0.000), and delayed conversion of sputum at the end of intensive phase (P value 0.000). Outcome for different regimens was not different significantly. Two specimens were isoniazid resistant. Conclusions. We suggest supervised treatment and care for diabetic patients and those with higher bacillary load. Paying attention to early diagnosis of tuberculosis in the elderly to reduce poor outcome and further measures to prevent transfer-out could improve the success rate.
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spelling pubmed-43103122015-02-04 Five-Year Assessment of Time of Sputum Smears Conversion and Outcome and Risk Factors of Tuberculosis Patients in Central Iran Behnaz, Fatemah Mohammadzadeh, Mahmoud Mohammadzade, Golnaz Tuberc Res Treat Research Article Objective. To evaluate risk factors which influence sputum smear conversion, outcome, and trends of conversion of sputum smear during 5 years and compare outcomes in patients with different regimens. Methods. In a retrospective cohort study, all patients with sputum smear positive tuberculosis were evaluated for comorbidities and demographic, microbiological, and therapeutic data and outcome. Smear examinations were performed at the beginning, at 2 months for CAT I, at 3 months for CAT II, at the end of second month of maintenance phase, and at the end of treatment. Results. This study enrolled 211 sputum smear positive patients, but 189 patients who completed the intensive phase of treatment were evaluated. Sputum smear of 158 patients converted at the end of intensive phase (83.6). Univariate analysis indicated that the risk of a persistent positive smear at the end of intensive phase was greater in diabetic patients ((odds 4.038, 95% CI 1.123–14.516) P = 0.033), and also a 3+bacillary load had risk of 2.933-fold ((95% CI 1.278–6.732) P = 0.011). Overall rate of unfavorable outcome was 20.9%. Factors associated with unfavorable outcome were age (P value 0.000), male gender (P value 0.027), diabetes (P value 0.000), and delayed conversion of sputum at the end of intensive phase (P value 0.000). Outcome for different regimens was not different significantly. Two specimens were isoniazid resistant. Conclusions. We suggest supervised treatment and care for diabetic patients and those with higher bacillary load. Paying attention to early diagnosis of tuberculosis in the elderly to reduce poor outcome and further measures to prevent transfer-out could improve the success rate. Hindawi Publishing Corporation 2015 2015-01-14 /pmc/articles/PMC4310312/ /pubmed/25653874 http://dx.doi.org/10.1155/2015/609083 Text en Copyright © 2015 Fatemah Behnaz et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Behnaz, Fatemah
Mohammadzadeh, Mahmoud
Mohammadzade, Golnaz
Five-Year Assessment of Time of Sputum Smears Conversion and Outcome and Risk Factors of Tuberculosis Patients in Central Iran
title Five-Year Assessment of Time of Sputum Smears Conversion and Outcome and Risk Factors of Tuberculosis Patients in Central Iran
title_full Five-Year Assessment of Time of Sputum Smears Conversion and Outcome and Risk Factors of Tuberculosis Patients in Central Iran
title_fullStr Five-Year Assessment of Time of Sputum Smears Conversion and Outcome and Risk Factors of Tuberculosis Patients in Central Iran
title_full_unstemmed Five-Year Assessment of Time of Sputum Smears Conversion and Outcome and Risk Factors of Tuberculosis Patients in Central Iran
title_short Five-Year Assessment of Time of Sputum Smears Conversion and Outcome and Risk Factors of Tuberculosis Patients in Central Iran
title_sort five-year assessment of time of sputum smears conversion and outcome and risk factors of tuberculosis patients in central iran
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310312/
https://www.ncbi.nlm.nih.gov/pubmed/25653874
http://dx.doi.org/10.1155/2015/609083
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