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Tuberculosis (TB) is a high burden global problem. Nigeria ranks fifth among the 22
high burden TB countries globally and first in Africa. Directly observed treatment short-
course (DOTS) is central to all TB control programs. One indicator of assessing the
effectiveness of DOTS is through sputum smear conversion rates at the end of intensive
phase. Whether some of the patients become smear negative early during the intensive
phase has not been investigated. There is lack of data to clarify this research question.
The rate and time to sputum smear conversion were determined as well as the
relationship between baseline sputum smear grades and time to sputum smear conversion
A longitudinal study at National Tuberculosis and Leprosy Training Center, (NTBLTC)
Zaria was employed from January-June 2010. Data collection was by laboratory method
using Ziehl Neelsen staining technique for grading the bacillary load in the sputum at
diagnosis and weekly follow-up specimens. HIV status of each patient was determined
and 2007-2009 records analyzed. Data was entered and analyzed by Epi-Info version
Of the 62 patients analyzed, 67.7% were males with male/female ratio of 2:1. The
productive age group constituted 88.7% of those affected with median age of 32 years.
About 75.8% were HIV negative with TB/HIV co-infection of 24.2%; 79% were new TB
patients. Overall, Zaria and her immediate neighboring LGAs had 82.3% of patients.
Of the 58 patients that converted, the mean time to sputum smear conversion was 2.7 ±
1.3 weeks, standard error (SE), 0.2 (95% confidence interval 2.3-3.1). Sputum smear
conversion rate peaked in week three with 71%. By the end of intensive phase,
conversion rate was 93.5%. At univariate analysis, by first week, 90% of sputum smear
grade of ≤ 1+ converted but none among sputum grade of 3+. Being HIV positive was
not associated with early conversion at bivariate analysis with p-value of 0.31 by Fisher’s
exact. Of the 611 records analyzed for 2007-2009, the average sputum conversion rate
was 82%. When conversion rate was categorized by sputum grade, it was statistically
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