Sputum Smear Conversion in Pulmonary Tuberculosis: An Intensive Phase Monitoring of Sputum Smear Positive Patients in Zaria, Nigeria

ABSTRACT

Tuberculosis (TB) is a high burden global problem. Nigeria ranks fifth among the 22 high burden TB countries globally and first in Africa. Directly observed treatment short-course (DOTS) is central to all TB control programs.
One indicator of assessing the effectiveness of DOTS is through sputum smear conversion rates at the end of the intensive phase. Whether some of the patients become smear-negative early during the intensive phase has not been investigated.

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There is a lack of data to clarify this research question. The rate and time to sputum smear conversion were determined as well as the relationship between baseline sputum smear grades and time to sputum smear conversion described.
In a longitudinal study at National Tuberculosis and Leprosy Training Center, (NTBLTC) Zaria was employed from January-June 2010.
Data collection was by laboratory method using Ziehl Neelsen staining technique for grading the bacillary load in the sputum at diagnosis and weekly follow-up specimens. HIV status of each patient was determined and 2007-2009 records were analyzed.
Data was entered and analyzed by Epi-Info version 3.5.1 Of the 62 patients analyzed, 67.7% were males with a male/female ratio of 2:1. The productive age group constituted 88.7% of those affected with a median age of 32 years.
About 75.8% were HIV negative with TB/HIV co-infection of 24.2%; 79% were new TB patients. Overall, Zaria and her immediate neighboring LGAs had 82.3% of patients.

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INTRODUCTION

Background of Study
Tuberculosis (TB), long known to be a major cause of morbidity and mortality throughout the world has for the past several decades been a neglected disease in both industrialized and developing countries.
Robert Koch in his presentation on the 24th March 1882 to the Physiological Society of Berlin on the discovery of Mycobacterium tuberculosis, an acid-fast bacillus that causes tuberculosis stated thus:
“If the importance of a disease for mankind is measured by the number of fatalities it causes, then tuberculosis must be considered much more important than those much-feared infectious diseases, plague, cholera, and the like.
One in seven of all human beings die from tuberculosis. If one considers the productive middle-age groups, tuberculosis carries away one-third and often more”. That burden still persists today and was thus declared as a “global emergency” by World Health Organization (WHO). ¹
The burden of TB of 1990 as a baseline for the global TB situation in the world has the following estimates: Approximately, one-third of the world’s population is infected with Mycobacterium tuberculosis.
An estimated eight million developed tuberculosis worldwide and 2.6 to 2.9 million died. ^{2, 3} Co-infection with human immunodeficiency virus (HIV) and multidrug-resistant TB has dramatically fueled the burden of TB. ³
Nigeria ranks fourth among the 22 high burden TB countries globally and first among nine African countries that are part of the 22 high burden countries.

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REFERENCES

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