scholarly journals P6‐67: Study on sputum non‐conversion at the end of intensive phase in smear positive pulmonary tuberculosis patients

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 255-256
Keyword(s):  
Pulmonary Tuberculosis ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Smear Positive Pulmonary Tuberculosis

scholarly journals Sputum Smears Conversion in Daily Versus Intermittent Treatment Regimen in New Sputum Smear Positive Pulmonary Tuberculosis Patients - A Retrospective Study

2021 ◽  
Vol 10 (42) ◽  
pp. 3617-3622
Author(s):  
Dhondiba Haribhau Bhise
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Regimen ◽  
Sputum Smear ◽  
Patient Death ◽  
Continuation Phase ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
National Tuberculosis ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Negative Conversion

BACKGROUND Sputum smear conversion is the negative conversion of the sputum smear at the end of the second month of treatment regimen under the National Tuberculosis Elimination Program (NTEP). When the acid-fast bacillus (AFB) smear comes negative at the end of an intensive phase, the treatment regimen can shift to the continuation phase that indicates bacillary load is a minimum. Although some authors consider the conversion of cultures when the AFB smear is negative, two potent drugs in the continuation phase are sufficient to kill the remaining bacilli. The drug that can kill bacteria in the first 2 days of treatment is called early bactericidal activity (EBA). This can be assessed by the percentage of negative conversion of cultures at the end of the intensive phase of the treatment regimen. EBA is very essential because it reduces the transmission in the community and chances of patient death. When the purpose is to kill as many bacilli as possible in the first few days and weeks of treatment, it is very important to include bactericidal drugs in the treatment regimen so that it reduces the chances of patient death and infectiousness and the negative conversion of the cultures after 2-month treatment regimen is an indication of the bactericidal capacity of the drug. The purpose of this study was to compare sputum smear conversion in daily versus intermittent treatment regimens in diagnosed cases of new sputum smear-positive pulmonary tuberculosis patients. METHODS This retrospective observational study was carried out in the Department of Respiratory medicine and nodal drug resistance tuberculosis centre (DR-TB) at the Government medical college and hospital, Akola. In this study, a total of 120 new patients were taken. 60 patients were given daily and intermittent regimens respectively under NTEP. RESULTS Out of 120 patients, 56 (93.33 %) patients in intermittent and 53 (88.33 %) patients in daily regimen were sputum smear-negative at the end of 2nd month (intensive phase) and at the end of 6th month (continuation phase). 1 patient (1.6 %) remained sputum smear-positive after the intensive phase. That patient was given 1 month of extension of anti-tuberculosis treatment (AKT) in the intensive phase and the patient became sputum negative after 1 month of extension. CONCLUSIONS It was concluded in this study, daily regimens and intermittent regimens were equally effective in negative conversion of the sputum smear at the end of the intensive phase and the end of the continuation phase. Negative conversion of the sputum smear is quite important because the bacillary load will be so low at the end of 2nd month that reduces the chances of patient death and transmission in the community. KEY WORDS Pulmonary Tuberculosis (PTB), Drug-Resistant TB (DR-TB), National Tuberculosis Programme (NTP), Revised National TB Control Program (RNTCP), Intensive Phase (IP), continuation Phase (CP), National Tuberculosis Elimination Program (NTEP).

scholarly journals Factors Influencing Sputum Conversion among Smear-Positive Pulmonary Tuberculosis Patients in Morocco

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Khalid Bouti ◽  
Mohammed Aharmim ◽  
Karima Marc ◽  
Mouna Soualhi ◽  
Rachida Zahraoui ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Stepwise Regression ◽  
Control Measures ◽  
Sputum Smear ◽  
Tuberculosis Patients ◽  
Infection Control Measures ◽  
Factors Influencing ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Sputum Conversion ◽  
A Prospective Study

Background. Sputum smear-positive pulmonary tuberculosis patients expel infectious viable bacilli for a period following the commencement of treatment. Objective. To determine the time to sputum smear conversion and study the factors influencing it. Design. A prospective study was undertaken at our hospital in Rabat over a six-month period on a cohort of 119 sputum smear positive patients. Patients were followed up fortnightly. At each followup, specimens were collected and processed for microscopy using standard protocol. Results. 96.6% of our patients completed the study (4 deaths). Sputum conversion rate was 42% after two weeks, 73% after one month, and 95% after two months. Univariate and stepwise regression analysis showed that patients who had high smear grading, miliary, and bilateral radiologic lesions were more likely to undergo delayed sputum conversion (P<0.05). Other factors were thought to influence sputum conversion but were not statistically proven in our study. Conclusion. Since viable bacilli continue to be expelled for up to two months, infection control measures should be maintained for such a time. Patients with high smear grading, miliary, and bilateral radiologic lesions need to be monitored more closely.

scholarly journals Identification of intestinal abnormalities in patients with active pulmonary tuberculosis using small bowel capsule endoscopy

2018 ◽  
Vol 06 (09) ◽  
pp. E1103-E1108 ◽  
Author(s):  
Miwako Saitou ◽  
Daiki Nemoto ◽  
Kenichi Utano ◽  
Tomoko Suzuki ◽  
Alan Kawarai Lefor ◽  
...  
Keyword(s):  
Small Bowel ◽  
Pulmonary Tuberculosis ◽  
Capsule Endoscopy ◽  
Primary Outcome ◽  
Ileocecal Valve ◽  
Tuberculosis Patients ◽  
Active Pulmonary Tuberculosis ◽  
Intestinal Lesions ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Small Intestinal

Abstract Background and study aims Mycobacterium tuberculosis is often detected in the feces of patients with active pulmonary tuberculosis. However, no study has examined the small intestine using small bowel capsule endoscopy (SBCE). This study aimed to investigate intestinal abnormalities in patients with active pulmonary tuberculosis. Patients and methods SBCE was performed in sputum/feces smear-positive pulmonary tuberculosis patients. From December 2013 to November 2016, 15 patients were enrolled from a dedicated tuberculous ward. The primary outcome was intestinal abnormalities identified by SBCE. Results Fourteen patients (median age 81 years, range 29 – 91; 3 female) underwent SBCE to the terminal ileum. The video was not recorded for one patient who was excluded from the analysis. Intestinal lesions, including 5 annular ulcers in 4 patients, were observed in 64 % (9/14). In subgroup analysis, prevalence tended to be higher in patients undergoing SBCE within 1 month of anti-tuberculous therapy (P = 0.051). Distribution of small intestinal lesions tended to be distal. Four of five annular ulcers were located close to the ileocecal valve. Conclusion Prevalence of intestinal lesions in patients with pulmonary tuberculosis is higher than expected before (UMIN 000017292)

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