{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:44:15Z","timestamp":1788903855602,"version":"build-2803163510"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>The treatment response of multi-drug resistance tuberculosis (MDR-Tuberculosis) patients is mainly dictated by the sputum culture conversion. An earlier culture conversion is a remarkable indicator of the improvement in the treatment response. In this study, we aimed to determine the time to culture conversion and its associated factors among MDR-Tuberculosis patients in All Africa Leprosy, Tuberculosis and Rehabilitation Training Center (ALERT) Hospital, Addis Ababa, Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective cohort study was conducted on 120 MDR-Tuberculosis patients attending ALERT Hospital from 2018\u20132022. Kaplan-Meier methods were used to determine the time to initial sputum culture conversion. All relevant laboratory, socio-demographic characteristics, and other clinical data were collected by chart abstraction using a structure data extraction form. The log-rank test was used to determine the survival rate. To identify the predictors of culture conversion, bivariate and multivariate Cox proportional hazard regression analysis was used. The hazard ratio (HR) with a 95% confidence interval was used to estimate the effect of each variable on the initial culture conversion. A test with a P value of &lt; 0.05 was considered statistically significant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>From the total of 120 study participants, 89.2% (107\/120) have shown a successful culture conversion. The median age of the participants was 30 years (IQR = 12). The study participants were followed for 408.6 person-months (34.05 person-years). The median time to initial sputum culture conversion was 80 days. The median time to initial sputum culture conversion among HIV-positive and HIV-negative participants was 61 days (IQR = 58\u201363.5) and 88 days (IQR = 75\u201391), respectively. HIV-negative and patients with previous treatment history were shown to be the predictor for a prolonged time to initial sputum culture conversion, (aHR = 0.24 (95% CI: 0.1\u20130.4), P value &lt;0.001) and (aHR = 0.47 (95% CI: 0.31\u20130.71), P value &lt;0.001) respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The median time to sputum culture conversion for HIV positive was found to be 61 days in our study. Notably, patients with a history of previous anti-tuberculosis treatment, HIV-negative status, and higher bacillary load at baseline exhibited delayed culture conversion. These findings underscore the importance of considering such patient characteristics in the management of MDR-TB cases, as tailored interventions and close monitoring may lead to more favorable treatment outcomes. By identifying individuals with these risk factors early in the treatment process, healthcare providers can implement targeted strategies to optimize patient care and improve overall treatment success rates in MDR-TB management programs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0304507","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T18:40:47Z","timestamp":1717180847000},"page":"e0304507","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Determinants of sputum culture conversion time in multidrug-resistant tuberculosis patients in ALERT comprehensive specialized hospital, Addis Ababa, Ethiopia: A retrospective cohort study"],"prefix":"10.1371","volume":"19","author":[{"given":"Muluye","family":"Abebe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7594-4004","authenticated-orcid":true,"given":"Abay","family":"Atnafu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3101-3926","authenticated-orcid":true,"given":"Melaku","family":"Tilahun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nejmia","family":"Sero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2033-5874","authenticated-orcid":true,"given":"Sebisib","family":"Neway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5860-7070","authenticated-orcid":true,"given":"Mekdes","family":"Alemu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getachew","family":"Tesfaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adane","family":"Mihret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kidist","family":"Bobosha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengsong","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"issue":"3","key":"pone.0304507.ref001","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.ijtb.2020.02.005","article-title":"A systemic review on tuberculosis","volume":"67","author":"A Natarajan","year":"2020","journal-title":"The Indian journal of tuberculosis"},{"key":"pone.0304507.ref002","unstructured":"WHO. Global TUberculosis Report. 2023."},{"issue":"1","key":"pone.0304507.ref003","first-page":"e20","volume":"4","author":"SJTLM Bagcchi","year":"2023","journal-title":"WHO\u2019s global tuberculosis report 2022"},{"issue":"Suppl 1","key":"pone.0304507.ref004","article-title":"Update of drug-resistant tuberculosis treatment guidelines: A turning point","volume":"130","author":"E Vanino","year":"2023","journal-title":"International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases"},{"key":"pone.0304507.ref005","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.ijid.2020.06.029","article-title":"Time to sputum culture conversion and its associated factors among multidrug-resistant tuberculosis patients in Eastern Africa: A systematic review and meta-analysis","volume":"98","author":"MA Assemie","year":"2020","journal-title":"International Journal of Infectious Diseases"},{"key":"pone.0304507.ref006","unstructured":"WHO. WHO consolidated guidelines on drug-resistant tuberculosis treatment: World Health Organization; 2019."},{"key":"pone.0304507.ref007","unstructured":"WHO. Guideline for Treatment of Drug Susceptible Tuberculosis and Patient Care. 2017."},{"issue":"3","key":"pone.0304507.ref008","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S2213-2600(15)00036-3","article-title":"Sputum culture conversion as a prognostic marker for end-of-treatment outcome in patients with multidrug-resistant tuberculosis: a secondary analysis of data from two observational cohort studies","volume":"3","author":"EV Kurbatova","year":"2015","journal-title":"The Lancet Respiratory medicine"},{"issue":"1","key":"pone.0304507.ref009","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1186\/s12879-021-06743-y","article-title":"High rates of culture conversion and low loss to follow-up in MDR-TB patients managed at Regional Referral Hospitals in Uganda","volume":"21","author":"MK Martin","year":"2021","journal-title":"BMC Infectious Diseases"},{"issue":"4","key":"pone.0304507.ref010","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.12669\/pjms.38.4.5058","article-title":"Time for culture conversion and its associated factors in multidrug-resistant tuberculosis patients at a tertiary level hospital in Peshawar, Pakistan","volume":"38","author":"Z Iqbal","year":"2022","journal-title":"Pak J Med Sci"},{"key":"pone.0304507.ref011","unstructured":"WHO, Initiative ST. Treatment of tuberculosis: guidelines: World Health Organization; 2010."},{"key":"pone.0304507.ref012","doi-asserted-by":"crossref","first-page":"3671","DOI":"10.2147\/IDR.S413495","article-title":"Time to Sputum Culture Conversion and Its Predictors Among Multidrug Resistant Tuberculosis Patients in Tigray, Northern Ethiopia: Retrospective Cohort Study","volume":"16","author":"L Weldemhret","year":"2023","journal-title":"Infection and Drug Resistance"},{"issue":"6","key":"pone.0304507.ref013","doi-asserted-by":"crossref","first-page":"e0198080","DOI":"10.1371\/journal.pone.0198080","article-title":"Time to sputum smear and culture conversions in multidrug resistant tuberculosis at University of Gondar Hospital, Northwest Ethiopia","volume":"13","author":"A Shibabaw","year":"2018","journal-title":"PLoS One"},{"issue":"50","key":"pone.0304507.ref014","doi-asserted-by":"crossref","first-page":"e23649","DOI":"10.1097\/MD.0000000000023649","article-title":"Time to sputum culture conversion and its predictors among patients with multidrug-resistant tuberculosis in Hangzhou, China: A retrospective cohort study","volume":"99","author":"Q Li","year":"2020","journal-title":"Medicine (Baltimore)"},{"issue":"6","key":"pone.0304507.ref015","doi-asserted-by":"crossref","first-page":"e0199320","DOI":"10.1371\/journal.pone.0199320","article-title":"Time to sputum culture conversion and its determinants among Multi-drug resistant Tuberculosis patients at public hospitals of the Amhara Regional State: A multicenter retrospective follow up study","volume":"13","author":"T Yihunie Akalu","year":"2018","journal-title":"PloS one"},{"key":"pone.0304507.ref016","doi-asserted-by":"crossref","first-page":"3671","DOI":"10.2147\/IDR.S413495","article-title":"Time to Sputum Culture Conversion and Its Predictors Among Multidrug Resistant Tuberculosis Patients in Tigray, Northern Ethiopia: Retrospective Cohort Study","volume":"16","author":"L Weldemhret","year":"2023","journal-title":"Infection and drug resistance"},{"issue":"1","key":"pone.0304507.ref017","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s40249-019-0594-9","article-title":"Trends and spatial distributions of HIV prevalence in Ethiopia","volume":"8","author":"GD Kibret","year":"2019","journal-title":"Infectious diseases of poverty"},{"key":"pone.0304507.ref018","unstructured":"WHO. Treatment of tuberculosis: guidelines for national programmes. Treatment of tuberculosis: guidelines for national programmes1997. p. 77-."},{"issue":"5","key":"pone.0304507.ref019","doi-asserted-by":"crossref","first-page":"e0197880","DOI":"10.1371\/journal.pone.0197880","article-title":"Comparison of the validity of smear and culture conversion as a prognostic marker of treatment outcome in patients with multidrug-resistant tuberculosis","volume":"13","author":"KA Alene","year":"2018","journal-title":"PloS one"},{"key":"pone.0304507.ref020","article-title":"<Time to sputum culture conversion in multidrug-resistant tuberculosis predictors and relationship to treatment outcome.pdf>","volume":"144","author":"H. Timothy","year":"2006","journal-title":"Annals of Internal Medicine"},{"issue":"9","key":"pone.0304507.ref021","doi-asserted-by":"crossref","first-page":"e108035","DOI":"10.1371\/journal.pone.0108035","article-title":"Time to culture conversion and regimen composition in multidrug-resistant tuberculosis treatment","volume":"9","author":"DB Tierney","year":"2014","journal-title":"PloS one"},{"issue":"1","key":"pone.0304507.ref022","first-page":"111","article-title":"Predictors of time to sputum culture conversion in multi-drug-resistant tuberculosis and extensively drug-resistant tuberculosis in patients at Tshepong-Klerksdorp Hospital","volume":"34","author":"R Ncha","year":"2019","journal-title":"S Afr J Infect Dis"},{"issue":"6","key":"pone.0304507.ref023","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.medici.2018.01.005","article-title":"Factors associated with sputum culture conversion in patients with pulmonary tuberculosis","volume":"53","author":"G Musteikien\u0117","year":"2017","journal-title":"Medicina"},{"issue":"6","key":"pone.0304507.ref024","doi-asserted-by":"crossref","first-page":"e0198080","DOI":"10.1371\/journal.pone.0198080","article-title":"Time to sputum smear and culture conversions in multidrug resistant tuberculosis at University of Gondar Hospital, Northwest Ethiopia","volume":"13","author":"A Shibabaw","year":"2018","journal-title":"PloS one"},{"issue":"1","key":"pone.0304507.ref025","doi-asserted-by":"crossref","DOI":"10.4081\/monaldi.2021.1678","article-title":"Factors associated with culture conversion among adults treated for pulmonary extensively drug-resistant tuberculosis during 2018\u20132019 in the Russian Federation: an observational cohort study","volume":"91","author":"A Russkikh","year":"2021","journal-title":"Monaldi Arch Chest Dis"},{"issue":"3","key":"pone.0304507.ref026","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1093\/jac\/dkv407","article-title":"Time to detection in liquid culture of sputum in pulmonary MDR-TB does not predict culture conversion for early discharge","volume":"71","author":"R Rieu","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"pone.0304507.ref027","author":"B Velayutham","journal-title":"Factors associated with sputum culture conversion in multidrug-resistant pulmonary tuberculosis"},{"issue":"1","key":"pone.0304507.ref028","article-title":"Culture Conversion Among HIV Co-Infected Multidrug-Resistant Tuberculosis Patients in Tugela Ferry, South Africa","volume":"6","author":"M Pai","year":"2011","journal-title":"PLoS ONE"},{"issue":"10","key":"pone.0304507.ref029","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.5588\/ijtld.11.0811","article-title":"Predictors of sputum culture conversion among patients treated for multidrug-resistant tuberculosis","volume":"16","author":"EV Kurbatova","year":"2012","journal-title":"The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0304507","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T18:41:06Z","timestamp":1717180866000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0304507"}},"subtitle":[],"editor":[{"given":"Tebelay","family":"Dilnessa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,5,31]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0304507","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,31]]}}}