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Delay in smear conversion was associated to failure and death.
Also, delay in smear conversion was associated to unfavorable treatment outcomes.
Pre-treatment smears graded 2+ and 3+ were independently associated to delay in smear conversion (p < 0.01).
Years of treatment ranging from 2009 to 2012 were also associated to delay in smear conversion (p < 0.02).
Delay in smear conversion was significantly associated to failure [Adjusted Odd Ratio (AOR):12.4 (Confidence Interval: CI 4.0- 39.0)] and death, AOR: 3.6 (CI 1.5- 9.0).
Cases with a B-notification were less likely to have smear-positive pulmonary disease (unsurprisingly, since smear-positive individuals are not assigned to class B and cannot legally enter the U.S. until treatment has resulted in smear conversion); nevertheless, some B-notification patients have smear-positive disease upon domestic follow-up.
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Heavy initial bacillary load has been documented (as in our study) as an important risk factor of delay in sputum smear conversion at the end of intensive phase of TB treatment [ 6, 7, 15- 17].
Therefore, the knowledge of associated risk factors to delay in sputum smear conversion at the end of the initiation phase of anti-tuberculosis treatment is necessary for care providers to prevent unfavorable outcomes.
Logistic regression models were used to evaluate the association of socio-demographic and clinical factors with delay in sputum smear conversion, and the association of this delay with treatment outcomes.
On the contrary, delay in sputum smear conversion at the end of the intensive phase of anti-tuberculosis treatment was not significantly associated to default (p = 0.56) and transfer (p = 0.29).
Overall, no significant differences were observed in sputum smear conversion rates (Additional file 2: Figure S2) or TB scores at weeks 4 (p 0.18), 8 (p 0.89) and 12 (p 0.16) between the 2 study arms.
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