FACTORS DELAYING SPUTUM CONVERSION IN SMEAR POSITIVE PULMONARY TUBERCULOSIS: A SYSTEMATIC REVIEW
Abstract
ABSTRACT
Background: Tuberculosis (TB) has existed for decades and remains a major global health problem globally and also in Malaysia. TB is one of the top ten causes of death worldwide. The pulmonary tuberculosis patients with sputum smear positive become the main source in transmitting the infection, in which one untreated patient able to infect another 10 to 15 person annually. Therefore, delayed sputum smear conversion is important clinically. Apart from a possible continuity of infectiousness, prior studies have indicated that delayed smear conversion is a risk factor for TB treatment failure, emergence of drug-resistant TB and potential increase in TB mortality. The aim of this article is to analyze the factors in delaying sputum conversion among smear positive pulmonary tuberculosis.
Materials and Methods: A scoping systematic review of literature using electronic databases of PubMed, ScienceDirect, Google Scholar was done on 19th to 25th February 2018. Subsequently, more articles and reports were identified by combing through the references from the relevant literatures. The search keywords include; ‘factors delayed sputum conversion’, ‘sputum positive’ and ‘sputum non conversion’.
Result and Discussion: A total of 454 articles and theses within past 10 years (2007-2017) were obtained and 20 articles were selected for final analysis. The analysis and findings are presented based on factors delaying sputum conversion. From previous studies, male gender, older age, unemployment, low BMI, having DM, HIV, smoker, alcohol consumption, high AFB load, advanced or cavitation in CXR, prolonged symptoms and non-adherence to TB treatment were significant factors in delaying sputum conversion.
Conclusion: A total of 454 articles and theses within past 10 years (2007-2017) were obtained and 20 articles were selected for final analysis. The analysis and findings are presented based on factors delaying sputum conversion. From previous studies, male gender, older age, unemployment, low BMI, having DM, HIV, smoker, alcohol consumption, high AFB load, advanced or cavitation in CXR, prolonged symptoms and non-adherence to TB treatment were significant factors in delaying sputum conversion.
Keywords: Factors of delayed, sputum conversion, pulmonary tuberculosis, smear positive