| Summary: | Introduction:
Tuberculosis remains a major health problem globally and in Malaysia, particularly in the
state of Sabah. Delayed sputum conversion is associated with treatment failure, drug-resistant tuberculosis and mortality. We aimed to determine the prevalence of delayed sputum
conversion among smear positive pulmonary tuberculosis (PTB) patients and its associated
factors in Sabah, Malaysia.
Methods:
A retrospective follow up study on all patients newly diagnosed with smear positive pulmonary tuberculosis from 2017 to 2019 was conducted at three government health clinics in
Sabah, utilizing data from a national electronic tuberculosis database and medical records.
Descriptive statistics and binary logistic regression were applied for data analysis. The outcome of the study was the sputum conversion status at the end of the two-month intensive
treatment phase with either successful conversion to smear negative or non-conversion.
Results:
374 patients were included in the analysis. Our patients were generally younger than 60
years old with no medical illness and varying proportions of tuberculosis severity as judged
by radiographic appearance and sputum bacillary load upon diagnosis. Foreigners constituted 27.8% of our sample. 8.8% (confidence interval: 6.2–12.2) did not convert to smear
negative at the end of the intensive phase. Binary logistic regression showed that older patients �60 years old (adjusted odds ratio, AOR = 4.303), foreigners (AOR = 3.184) and
patients with higher sputum bacillary load at diagnosis [2+ (AOR = 5.061) and 3+ (AOR =
4.992)] were more likely to have delayed sputum smear conversion.
Conclusion:
The prevalence of delayed sputum conversion in our study was considerably low at 8.8%
with age �60 years old, foreigners and higher pre-treatment sputum bacillary load associated with delayed conversion. Healthcare providers should take note of these factors and
ensure the patients receive proper follow up treatment.
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