Predominant Determinants of Delayed Tuberculosis Sputum Conversion in Indonesia

Context Sputum conversion in the first 2 months of tuberculosis (TB) treatment is closely related to successful treatment and a decrease in the likelihood of relapse. In 2015, there were 76% high TB burden countries with low rate of TB successful treatment. Aims This study aims to evaluate the correlation between delayed sputum conversion and several determinants including social determinants, smoking, malnutrition, and type II diabetes mellitus (DM). Settings and design A case-control approach was used to study the potential determinants. A case sample group consisted of smear-positive TB patients with delayed sputum conversion (31 patients) at community health centers in Bandar Lampung, Indonesia. Meanwhile, a control sample group consisted of smear-positive TB patients with sputum conversion (62 patients). Subjects and methods Primary data consisted of social determinants and smoking, were collected through in-depth interviews. Meanwhile, secondary data consisted of malnutrition, DM, and sputum conversion were obtained from the medical record. Statistical analysis used Data were analyzed using Chi-square and multivariate logistic regression. Results Low education (odds ratio [OR]: 5.313; 95% (confidence interval [CI]: 1.711-16.503), low social class (OR: 4.993; 95% CI: 1.430-17.430), smoking (OR: 7.457; 95% CI: 1.757-31.640), and DM (OR: 7.168; 95% CI: 1.746-29.431) influenced delayed sputum conversion. Conclusions TB control programs in high TB burden countries with low rate of TB successful treatment, should be integrate TB treatment education, smoking cessation programs and follow-up treatments for TB patients with DM to improve the probability of sputum conversion and successful treatment.