Last modified: 2020-02-11
Abstract
Introduction: Early sputum culture conversion has been reported as a predictor of treatment success and a cardinal index in monitoring treatment response in multidrug-resistance tuberculosis (MDR-TB) patients. Therefore, the aim of this study is to consider the evidence to pool the median time to culture conversion in eastern Africa.
Methods: We systematically extract available articles on multidrug-resistance tuberculosis treatment culture conversion among adult patients in eastern Africa by using a number of computerized databases, including PubMed, Scopus, Cochrane Library, and Science Direct. Two authors independently extracted relevant data using a standardized data extraction form. Heterogeneity among included studies was assessed with the Cochrane Q test statistics and Higgins I2 tests. The pooled sputum culture conversion median time were assessed with random-effects model using R 3.6.1 version software.
Result: From this systematic review and meta-analysis, the mean age of MDR-TB patients on treatment was 31.9 years. The median time of sputum culture conversion was in the range of 34 and 90 days. This review includes nine articles and 2,819 total MDR-TB patient samples with the smallest sample size 16 and the largest 634. The pooled median time of sputum culture conversion was found 61.2 days (IQR: 48.6, 73.8).In addition we have found the two month culture conversion rate 74.8 %( 95% CI: 67.2, 82.5). Treatment outcomes of MDR-TB was 65 %( 95%CI: 47.8, 82.3) successful, 10 %( 95%CI: 6, 14) deaths and 3 %( 95%CI: 0, 5%) treatment failure 10% (95%CI: 4, 17) lost to follow-up. The only independent determinate factor for delayed sputum culture conversion is low body mass index below 18.5kg/meter2 (OR = 0.32, 95% CI: 0.15, 0.5).
Conclusion: The median sputum culture conversion time is found 61.2 days which is at reasonable shorter time. Body mass index, is the predictors of delayed culture conversion. Therefore, awareness creation on how to improve nutrition status of MDR-TB patient and nutritional supports.