Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study
OBJECTIVE: To characterize time to sputum conversion among patients with multidrug resistant tuberculosis who were enrolled into second-line tuberculosis treatment program; to identify risk factors for delayed sputum conversion. DESIGN: Retrospective cohort study designed to identify the factors ass...
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Makhdoomi Printers
2012-06-01
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doaj-96005d089bc14974afaa868b11fb6b572020-11-25T02:02:58ZengMakhdoomi PrintersGlobal Journal of Medicine and Public Health 2277-96042012-06-0113Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort studyArax HovhannesyanElizabeth BreezeOBJECTIVE: To characterize time to sputum conversion among patients with multidrug resistant tuberculosis who were enrolled into second-line tuberculosis treatment program; to identify risk factors for delayed sputum conversion. DESIGN: Retrospective cohort study designed to identify the factors associated with sputum conversion. Survival analysis was performed using Kaplan-Meier estimator to compute estimates for median time to sputum conversion and Cox proportional hazards model to compute hazard ratios (HR). RESULTS: Sputum conversion from positive to negative was observed in 134 out of 195 cases (69%). Among these who converted the median time to conversion was 3.7 months. Factors independently associated with time to sputum conversion in the proportional hazards model were: male sex (HR=0.51, 95% CI 0.32-0.81), ofloxacin-resistant tuberculosis (HR = 0.45, 95% CI 0.26-0.78) and first period of recruitment into second-line treatment (HR= 0.69, 95% CI 0.47-1.01). CONCLUSION: Time to sputum conversion in patients with multidrug-resistant tuberculosis in Armenia was 5.8 months (range 0.5-17.0 months). High level of ofloxacin resistance was the main reason for compromised response to treatment. Patients with a poor resistance profile and males should be targeted with more aggressive initial therapy. http://www.gjmedph.org/uploads/O5-Vo1No3.pdfDOTS-PlusMDR-TBsputum conversionArmenia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Arax Hovhannesyan Elizabeth Breeze |
spellingShingle |
Arax Hovhannesyan Elizabeth Breeze Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study Global Journal of Medicine and Public Health DOTS-Plus MDR-TB sputum conversion Armenia |
author_facet |
Arax Hovhannesyan Elizabeth Breeze |
author_sort |
Arax Hovhannesyan |
title |
Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study |
title_short |
Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study |
title_full |
Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study |
title_fullStr |
Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study |
title_full_unstemmed |
Time to sputum conversion in multidrug-resistant tuberculosis patients in Armenia: retrospective cohort study |
title_sort |
time to sputum conversion in multidrug-resistant tuberculosis patients in armenia: retrospective cohort study |
publisher |
Makhdoomi Printers |
series |
Global Journal of Medicine and Public Health |
issn |
2277-9604 |
publishDate |
2012-06-01 |
description |
OBJECTIVE: To characterize time to sputum conversion among patients with multidrug resistant tuberculosis who were enrolled into second-line tuberculosis treatment program; to identify risk factors for delayed sputum conversion. DESIGN: Retrospective cohort study designed to identify the factors associated with sputum conversion. Survival analysis was performed using Kaplan-Meier estimator to compute estimates for median time to sputum conversion and Cox proportional hazards model to compute hazard ratios (HR). RESULTS: Sputum conversion from positive to negative was observed in 134 out of 195 cases (69%). Among these who converted the median time to conversion was 3.7 months. Factors independently associated with time to sputum conversion in the proportional hazards model were: male sex (HR=0.51, 95% CI 0.32-0.81), ofloxacin-resistant tuberculosis (HR = 0.45, 95% CI 0.26-0.78) and first period of recruitment into second-line treatment (HR= 0.69, 95% CI 0.47-1.01). CONCLUSION: Time to sputum conversion in patients with multidrug-resistant tuberculosis in Armenia was 5.8 months (range 0.5-17.0 months). High level of ofloxacin resistance was the main reason for compromised response to treatment. Patients with a poor resistance profile and males should be targeted with more aggressive initial therapy. |
topic |
DOTS-Plus MDR-TB sputum conversion Armenia |
url |
http://www.gjmedph.org/uploads/O5-Vo1No3.pdf |
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AT araxhovhannesyan timetosputumconversioninmultidrugresistanttuberculosispatientsinarmeniaretrospectivecohortstudy AT elizabethbreeze timetosputumconversioninmultidrugresistanttuberculosispatientsinarmeniaretrospectivecohortstudy |
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