ArticleBMC infectious diseases2016
Risk factors for tuberculosis smear non-conversion in Eden district, Western Cape, South Africa, 2007-2013: a retrospective cohort study.
Article in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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19 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis.PloS one · 2019Pooled it
- Preferences for TB treatment and support delivery models among people living with TB in Eastern Cape, South Africa: a discrete choice experiment.Journal of the International AIDS Society · 2025Article
- Social isolation, social exclusion, and access to mental and tangible resources: mapping the gendered impact of tuberculosis-related stigma among men and women living with tuberculosis in Eastern Cape Province, South Africa.BMC global and public health · 2025Article
- A study on factors influencing delayed sputum conversion in newly diagnosed pulmonary tuberculosis based on bacteriology and genomics.Scientific reports · 2024Article
- Prevalence, Clinical Characteristics and Determinants of Unsuccessful Treatment Outcomes Among Pulmonary Tuberculosis Patients: A 5-Year Registry-Based Retrospective Cohort Study.Patient related outcome measures · 2024Article
- Prevalence and factors associated with sputum smear non-conversion after two months of tuberculosis treatment among smear-positive pulmonary tuberculosis patients in Rwanda: a cross-sectional study.BMC infectious diseases · 2023Article
- Placing the values and preferences of people most affected by TB at the center of screening and testing: an approach for reaching the unreached.BMC global and public health · 2023Article
- A mixed methods study on men's and women's tuberculosis care journeys in Lusaka, Zambia-Implications for gender-tailored tuberculosis health promotion and case finding strategies.PLOS global public health · 2023Article
- Association between sputum conversion and in-hospital mortality in elderly patients with pulmonary tuberculosis: a retrospective study.BMC infectious diseases · 2022Article
- Epidemiology and Risk Factors of Delayed Sputum Smear Conversion in Malaysian Aborigines with Smear-Positive Pulmonary Tuberculosis.International journal of environmental research and public health · 2022Article
- Article
- Treatment outcomes of Gene Xpert positive tuberculosis patients in KwaMashu Community Health Centre, KwaZulu-Natal, South Africa: A retrospective review.Southern African journal of infectious diseases · 2021Article
- South Africa field epidemiology training program: developing and building applied epidemiology capacity, 2007-2016.BMC public health · 2019Article
- Determinants of sputum smear nonconversion in smear-positive pulmonary tuberculosis patients in Suriname, 2010 - 2015.Revista panamericana de salud publica = Pan American journal of public health · 2019Article
- Longitudinal body weight and sputum conversion in patients with tuberculosis, Southwest Ethiopia: a retrospective follow-up study.BMJ open · 2018Article
- Analysis of tuberculosis treatment outcomes among pulmonary tuberculosis patients in Bahawalpur, Pakistan.BMC research notes · 2018Article
- Evaluating the electronic tuberculosis register surveillance system in Eden District, Western Cape, South Africa, 2015.Global health action · 2017Article
- Navigating Masculinities: An Exploration of Peer Coaching, Health Behaviors, and Mortality Risks Among Men in Tuberculosis and HIV Interventions in South Africa.American journal of men's healthArticle
- Qualitative Identification of Intervention Preferences to Support Men's Engagement and Retention in TB Care in South Africa.American journal of men's healthArticle
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8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundTuberculosis (TB) continues to be a major global health problem. While progress has been made to improve TB cure rates, South Africa's 76 % smear-positive pulmonary TB (PTB) case cure rate remains below the WHO target of 85 %. We report on the trends of TB smear non-conversion and their predictors at the end of an intensive phase of treatment, and how this impacted on treatment outcomes of smear-positive PTB cases in Eden District, Western Cape Province, South Africa.
methodsRoutinely collected, retrospective data of smear-positive PTB cases from the electronic TB register in Eden District between 2007 and 2013 was extracted. Non-conversion was defined as persistent sputum smear-positive PTB cases at the end of the two or three month intensive phase of treatment. Chi-square test for linear trend and simple linear regression analysis were used to analyse the change in percentages and slope of TB smear non-conversion rates over time. Risk factors for TB non-conversion, and their impact on treatment outcomes, were evaluated using logistic regression models.
resultsOf 12,742 total smear-positive PTB cases included in our study, 12.8 % (n = 1627) did not sputum smear convert; 13.3 % (1411 of 10,574) of new cases and 9.9 % (216 of 2168) of re-treatment cases. Although not statistically significant in either new or re-treatment cases, between 2007 and 2013, smear non-conversion decreased from 16.4 to 12.7 % (slope = -0.60; 95 % CI: -1.49 to 0.29; p = 0.142) in new cases, and from 11.3 to 10.8 % in re-treatment cases (slope = -0.29; 95 % CI: -1.06 to 0.48; p = 0.376). Male gender, HIV co-infection and a >2+ acid fast bacilli (AFB) smear grading at the start of TB treatment were independent risk factors for non-conversion (p < 0.001). Age was a risk factor for non-conversion in new cases, but not for re-treatment cases. Non-conversion was also associated with unsuccessful treatment outcomes (p < 0.01), including treatment default and treatment failure.
conclusionsSmear-positive PTB cases, especially men and those with identified risk factors for non-conversion, should be closely monitored throughout their treatment period. The South African TB control program should invest in patient adherence counselling and education to mitigate TB non-conversion risk factors, and to improve conversion and TB cure rates.
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