Abstract:

Objective: To analyze the influencing factors of delayed sputum smear conversion after intensive treatment of pulmonary tuberculosis patients, and provide scientific evidence for promoting sputum conversion and improving treatment effectiveness. Methods: Through the TB Information Management System of the Chinese Disease Prevention and Control Information System, information of etiologically positive patients registered and reported in Weifang Second People's Hospital of Shandong Province from January 1, 2019 to December 31, 2022 were collected. With inclusion and exclusion criteria, a total of 455 patients with tuberculosis were included in the study. Basic information such as age, gender, height, weight, and diabetes history was collected. Data analysis were conducted using SPSS 20.0 software. Logistic regression analysis was used to investigate the factors that influenced delayed sputum smear conversion. Results: After receiving intensive treatment, 299 patients showed negative results in their sputum tests, while 156 patients still tested positive. The rate of sputum bacteria turning negative was 65.7%. Logistic regression analysis indicated that certain factors were associated with delayed conversion, including diabetes (OR (95%CI)=1.859 (1.096-3.153)), complications (OR (95%CI)=1.855 (1.117-3.082)), sputum bacillary load being ++++ (OR (95%CI)=3.529 (1.063-11.715)), hypoproteinemia (OR (95%CI)=1.749 (1.040-2.943)), and anemia (OR (95%CI)=2.398 (1.412-4.070)). Conclusion: Patients with tuberculosis who also have diabetes, complications, sputum bacillary load being ++++, hypoalbuminemia, and anemia are at a higher risk for delayed sputum smear conversion. Identifying and correcting these risk factors timely can help patients achieve sputum negative conversion, reduce the risk of transmission, and prevent adverse prognosis.

Key words: Tuberculosis, pulmonary, Sputum, Factor analysis, statistical