Association Between Incomplete Sputum Smear Monitoring and Treatment Success in Pulmonary Tuberculosis
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Abstract
Background: The six-month treatment regimen for pulmonary tuberculosis (TB) includes sputum monitoring at months two, five, and six. However, due to patient limitations, healthcare resource constraints, and service disruptions during the COVID-19 pandemic, some patients were unable to complete all three follow-ups. This study aimed to investigate the association between incomplete sputum smear monitoring and treatment success among patients with pulmonary TB.
Design: Retrospective cohort study
Methods: The medical records were analyzed for new or relapsed cases of adult pulmonary TB patients treated at Khon Kaen Hospital between 2021 and 2023. Patients were categorized into two groups: the incomplete monitoring group (missing ≥ one smear at months two, five, or six), and the complete group (smears at all three points). The primary outcome was treatment success, defined as cure or treatment completion. Crude analysis was performed using Fisher’s exact test. Poisson regression with robust standard errors was used to estimate adjusted relative risk (aRR).
Results: Of 396 patients, 223 were in the incomplete group and 173 in the complete group. The treatment success rate was 100% in the incomplete group and 98.8% in the complete group. The crude relative risk was 1.012 (95% CI: 0.996-1.028). After adjustment for age, sex, comorbidities, smoking, and alcohol use, the association remained in the same direction, with an aRR of 1.015 (95% CI: 0.995-1.036).
Conclusions: Incomplete sputum smear monitoring was not associated with the treatment success rate among pulmonary TB patients.
Keywords: pulmonary tuberculosis, sputum smear monitoring, treatment success
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