Initial Sputum Smear Grading As a Factor To Predict Treatment Outcome In New Sputum Smear Positive Pulmonary Tuberculosis

Vishal Chopra; Don Gregory Mascarenhas; Ashrafjit S Chahal; Jawahar Lal Joshi; Siddharth Chopra; Hardik Jain

Volume : VII, Issue : III, March - 2017

Initial Sputum Smear Grading As a Factor To Predict Treatment Outcome In New Sputum Smear Positive Pulmonary Tuberculosis

Vishal Chopra, Don Gregory Mascarenhas, Ashrafjit S Chahal, Jawahar Lal Joshi, Siddharth Chopra, Hardik Jain

Abstract :

Objective: To assess the association between the initial sputum smear grading, sputum conversion rate at two months of ATT and treatment outcomes at the end of treatment in new sputum smear positive patients. Methods: a prospective study was done in 500 new smear positive TB patients coming to TB hospital Patiala. Initial sputum was graded as low (scanty and +1) and high (+2 and +3). The patients were treated as per the revised national tuberculosis programme (RNTCP) guidelines. Sputum conversion was assessed at 2 or 3 months and treatment outcome was analysed. Results: Sputum conversion rates among low and high grades at the end of two and three months was statistically significant (p<0.0001 and <0.004). Cure rate was also found to be statistically significant p<0.047. Default, death and failure rate was also very high in patients with high grade of sputum. Conclusion: Patients with initial high bacterial load are at risk of low sputum conversion rate and low cure rate. Death, default and failure rate are linearly related to increasing initial bacterial load and increasing age whereas cure rate is inversely related. Initial sputum grading, sputum conversion rate and advancing age appear to be strong predictors of treatment outcome.