Epidemiology & Biostatistics PhD trainee Lentlametse Mantshonyane presenting.
Title: Predictors of Early Tuberculosis Treatment Response: A Multi-feature Analysis of Bandim TBScore, Chest Radiography and Clinical Indicators
Overview:
Tuberculosis (TB) is the leading infectious cause of death worldwide, with an estimated 1.25 million deaths in 2023.It is caused by the bacterium Mycobacterium tuberculosis (Mtb). Although most people infected with Mtb do not develop active TB disease, in those who do, there is variation in the disease course, severity and treatment outcomes. Among people diagnosed with pulmonary tuberculosis (PTB), one of the most important treatment and programmatic goals of care is to eliminate the Mtb from the sputum of a patient within the first two months of treatment, often referred to as two-month sputum conversion. Failure to convert correlates with poor long-term outcomes and may require other more intensive follow-up or treatment. However, predictors of two-month sputum conversion has proven difficult to understand as they it can vary by context, including clinical setting.
One possible predictor of conversion is severity of disease at diagnosis. However, it is unknown how severity grading metrics relate to two-month culture conversion. In this study, we analyzed 718 index TB cases enrolled in “The Kawempe Community Health Study (KCHS)”; a household contact study that enrolled from 2002–2012. We analyzed demographics, clinical, microbiological, radiological, household and behavioral data for their association with culture conversion. We also evaluated how well two TB severity grading metrics; the chest Xray score and the Bandim TBScore predict two months culture conversion. Although several variables did associate with conversion the ability to predict using these was weak, indicating that additional work is necessary, perhaps by examining context specific effects in larger studies.
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