Review of Organism Density and Bacteriologic Conversion of Sputum among Tuberculosis Patients
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Auteurs : Francis Adjei Osei [Ghana] ; Anthony Enimil [Ghana] ; Daniel Ansong [Ghana] ; Dennis Odai Laryea [Ghana] ; Nicholas Karikari Mensah [Ghana] ; Evans Xorse Amuzu [Ghana] ; Ebenezer Opambour Agyemang [Ghana] ; Phans Oduro Sarpong [Ghana] ; Isaac Nyanor [Ghana] ; Denis Dekugmen Yar [Ghana]Source :
- International Scholarly Research Notices [ 2356-7872 ] ; 2017.
Abstract
This study sought to describe the trend of sputum organism density and the rate of bacteriological conversion among smear positive TB patients assessing care at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.
We conducted a retrospective patient folder review from January 2013 to March 2016 at the KATH, a tertiary hospital in Ghana. The data was entered into Microsoft Access database and exported into STATA for analysis. We applied basic descriptive statistics to study variables. Sputum conversion rate (SCR) was estimated using the number of negative tests recorded over a period (numerator) and the number of patients reported in the same period (denominator) and expressed as a percentage.
A total of 278 patient records with sputum smear positive at onset were studied. Before treatment sputum density detected in smear microscopy was as follows: 1 acid-fast bacillus (+) (
This study has shown an increasing trend in sputum conversion of smear positive pulmonary tuberculosis and an increasing trend in loss to follow-ups among tuberculosis patients on treatment.
Url:
DOI: 10.1155/2017/7052583
PubMed: 28781995
PubMed Central: 5525070
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p> This study sought to describe the trend of sputum organism density and the rate of bacteriological conversion among smear positive TB patients assessing care at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.</p>
</sec>
<sec><title> Methods</title>
<p> We conducted a retrospective patient folder review from January 2013 to March 2016 at the KATH, a tertiary hospital in Ghana. The data was entered into Microsoft Access database and exported into STATA for analysis. We applied basic descriptive statistics to study variables. Sputum conversion rate (SCR) was estimated using the number of negative tests recorded over a period (numerator) and the number of patients reported in the same period (denominator) and expressed as a percentage.</p>
</sec>
<sec><title> Results</title>
<p> A total of 278 patient records with sputum smear positive at onset were studied. Before treatment sputum density detected in smear microscopy was as follows: 1 acid-fast bacillus (+) (<italic>n</italic>
= 114), scanty (<italic>n</italic>
= 19), ++ (<italic>n</italic>
= 67), and +++ (<italic>n</italic>
= 78). We recorded sputum conversion rate of 80.90%, 94.56%, and 98.31% in the intensive, continuation, and completion phases, respectively.</p>
</sec>
<sec><title> Conclusion</title>
<p> This study has shown an increasing trend in sputum conversion of smear positive pulmonary tuberculosis and an increasing trend in loss to follow-ups among tuberculosis patients on treatment.</p>
</sec>
</div>
</front>
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<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
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</article-categories>
<title-group><article-title>Review of Organism Density and Bacteriologic Conversion of Sputum among Tuberculosis Patients</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-1094-813X</contrib-id>
<name><surname>Osei</surname>
<given-names>Francis Adjei</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Enimil</surname>
<given-names>Anthony</given-names>
</name>
<xref ref-type="aff" rid="I3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ansong</surname>
<given-names>Daniel</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="I3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Laryea</surname>
<given-names>Dennis Odai</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mensah</surname>
<given-names>Nicholas Karikari</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Amuzu</surname>
<given-names>Evans Xorse</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Agyemang</surname>
<given-names>Ebenezer Opambour</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sarpong</surname>
<given-names>Phans Oduro</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nyanor</surname>
<given-names>Isaac</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dekugmen Yar</surname>
<given-names>Denis</given-names>
</name>
<xref ref-type="aff" rid="I4"><sup>4</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
Public Health Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana</aff>
<aff id="I2"><sup>2</sup>
Research and Development Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana</aff>
<aff id="I3"><sup>3</sup>
Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana</aff>
<aff id="I4"><sup>4</sup>
Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</aff>
<author-notes><corresp id="cor1">*Francis Adjei Osei: <email>francisph1@hotmail.com</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Nikolaos G. Koulouris</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<pub-date pub-type="epub"><day>11</day>
<month>7</month>
<year>2017</year>
</pub-date>
<volume>2017</volume>
<elocation-id>7052583</elocation-id>
<history><date date-type="received"><day>23</day>
<month>3</month>
<year>2017</year>
</date>
<date date-type="rev-recd"><day>1</day>
<month>6</month>
<year>2017</year>
</date>
<date date-type="accepted"><day>14</day>
<month>6</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2017 Francis Adjei Osei et al.</copyright-statement>
<copyright-year>2017</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>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.</license-p>
</license>
</permissions>
<abstract><sec><title>Objective</title>
<p> This study sought to describe the trend of sputum organism density and the rate of bacteriological conversion among smear positive TB patients assessing care at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.</p>
</sec>
<sec><title> Methods</title>
<p> We conducted a retrospective patient folder review from January 2013 to March 2016 at the KATH, a tertiary hospital in Ghana. The data was entered into Microsoft Access database and exported into STATA for analysis. We applied basic descriptive statistics to study variables. Sputum conversion rate (SCR) was estimated using the number of negative tests recorded over a period (numerator) and the number of patients reported in the same period (denominator) and expressed as a percentage.</p>
</sec>
<sec><title> Results</title>
<p> A total of 278 patient records with sputum smear positive at onset were studied. Before treatment sputum density detected in smear microscopy was as follows: 1 acid-fast bacillus (+) (<italic>n</italic>
= 114), scanty (<italic>n</italic>
= 19), ++ (<italic>n</italic>
= 67), and +++ (<italic>n</italic>
= 78). We recorded sputum conversion rate of 80.90%, 94.56%, and 98.31% in the intensive, continuation, and completion phases, respectively.</p>
</sec>
<sec><title> Conclusion</title>
<p> This study has shown an increasing trend in sputum conversion of smear positive pulmonary tuberculosis and an increasing trend in loss to follow-ups among tuberculosis patients on treatment.</p>
</sec>
</abstract>
</article-meta>
</front>
<floats-group><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Distribution of patients by sex, age groupings, and HIV status.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Variable</th>
<th align="center" rowspan="1" colspan="1">Frequency (<italic>N</italic>
= 278)</th>
<th align="center" rowspan="1" colspan="1">Percentage</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1"><italic>Age</italic>
</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">18–30 years</td>
<td align="center" rowspan="1" colspan="1">80</td>
<td align="center" rowspan="1" colspan="1">28.78</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">31–50 years</td>
<td align="center" rowspan="1" colspan="1">139</td>
<td align="center" rowspan="1" colspan="1">50</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">51–70 years</td>
<td align="center" rowspan="1" colspan="1">50</td>
<td align="center" rowspan="1" colspan="1">17.99</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">71 years and above</td>
<td align="center" rowspan="1" colspan="1">9</td>
<td align="center" rowspan="1" colspan="1">3.24</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Median (IQR)</td>
<td colspan="2" align="center" rowspan="1">38 (30, 48)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Sex</italic>
</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Male</td>
<td align="center" rowspan="1" colspan="1">162</td>
<td align="center" rowspan="1" colspan="1">58.27</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Female</td>
<td align="center" rowspan="1" colspan="1">116</td>
<td align="center" rowspan="1" colspan="1">41.73</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>HIV status</italic>
</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Positive</td>
<td align="center" rowspan="1" colspan="1">51</td>
<td align="center" rowspan="1" colspan="1">18.35</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Negative</td>
<td align="center" rowspan="1" colspan="1">100</td>
<td align="center" rowspan="1" colspan="1">35.97</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Not recorded</td>
<td align="center" rowspan="1" colspan="1">127</td>
<td align="center" rowspan="1" colspan="1">45.68</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Trend of smear positive results recorded before treatment through to the end of treatment.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="left" colspan="1">Monitoring period</th>
<th colspan="7" align="center" rowspan="1">Sputum conversion results</th>
</tr>
<tr><th align="center" rowspan="1" colspan="1">Negative</th>
<th align="center" rowspan="1" colspan="1">Scanty</th>
<th align="center" rowspan="1" colspan="1">+</th>
<th align="center" rowspan="1" colspan="1">++</th>
<th align="center" rowspan="1" colspan="1">+++</th>
<th align="center" rowspan="1" colspan="1"><sup><italic>∗</italic>
</sup>
SCR</th>
<th align="center" rowspan="1" colspan="1"><sup><italic>∗∗</italic>
</sup>
LTFU</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Monitoring before treatment <italic>n</italic>
= 278</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">19</td>
<td align="center" rowspan="1" colspan="1">114</td>
<td align="center" rowspan="1" colspan="1">67</td>
<td align="center" rowspan="1" colspan="1">78</td>
<td align="center" rowspan="1" colspan="1">—</td>
<td align="center" rowspan="1" colspan="1">—</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Monitoring at 2-3 months after treatment <italic>n</italic>
= 278</td>
<td align="center" rowspan="1" colspan="1">144</td>
<td align="center" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">20</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">80.90</td>
<td align="center" rowspan="1" colspan="1">100</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Monitoring at 5 months after treatment <italic>n</italic>
= 178</td>
<td align="center" rowspan="1" colspan="1">139</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">94.56</td>
<td align="center" rowspan="1" colspan="1">31</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Monitoring at end of treatment <italic>n</italic>
= 147</td>
<td align="center" rowspan="1" colspan="1">116</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">98.31</td>
<td align="center" rowspan="1" colspan="1">29</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p><sup><italic>∗</italic>
</sup>
SCR = sputum conversion rate; <sup><italic>∗∗</italic>
</sup>
LTFU = loss to follow-up.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
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