Background Sputum culture conversion status is a cardinal index of treatment response and patient outcome for MDR TB patients on longer anti-TB drugs. But, there is limited information on time to sputum culture conversion of MDR TB patients on a longer anti-TB treatment regimen. Therefore, this study aimed to evaluate time to sputum culture conversion and its predictors among MDR TB patients in Tigray, Northern Ethiopia. Methods A retrospective cohort study was conducted from January 2017 through September 2020 among MDR TB patients in Tigray, Northern Ethiopia. Demographic and clinical characteristics including bacteriological data were extracted from the TB registration book and electronic database in Tigray Health Research Institute. Statistical analysis was performed using SPSS version 25. The time to initial sputum culture conversion was analyzed using the Kaplan–Meier method. Bivariate and multivariate Cox proportional hazards regression analyses were used to identify predictors for culture conversions. P <0.05 was considered statistically significant. Results A total of 294 eligible study participants with a median age of 30 years (IQR: 22.75–40) were included. The participants were followed for a total of 1066.7 person months. Sputum culture conversion was achieved in 269 (91%) of the study participants. The median time of sputum culture conversion was 64 days (IQR: 49–86). In our multivariate model, HIV-positive (aHR=1.529, 95% CI: 1.096–2.132, P=0.012), patients new to anti-TB treatment (aHR=2.093, 95% CI: 1.100–3.982, P=0.024) and baseline AFB smear grading of +1 (aHR=1.982, 95% CI: 1.428–2.750, P=0.001) significantly affected time to initial sputum culture conversion. Conclusion The median time of culture conversion was 64 days. Moreover, the majority of the study participants achieved culture conversion within the first six months of treatment commencement, which supports predefined standard treatment durations.

Introduction Tuberculosis disease is the leading cause of death worldwide along with HIV/AIDS. Sputum smear microscopy plays an essential role for initial TB diagnosis and treatment follow up. But, misdiagnosis of sputum smear microscopy revealed a high economical crisis and missing of active TB cases. This study was aimed to determine blinded rechecking of sputum smear microscopy performance in public health facilities in Tigray region, Northern Ethiopia. Materials and methods A cross sectional retrospective study was conducted from January, 2017 to December, 2018 year. Data was collected retrospectively using electronic and paper based in Tigray health research institute. The data was analyzed using the SPSS version 25 software. The sensitivity, specificity, positive predictive value, and negative predictive value of the smear readings were calculated using 2X2 contingency table. The reading agreement between the microscopic center and reference center was determined using kappa statistics. Results A total of 23,456 blinded rechecked smear results were reviewed. In average, the performances of sputum smear quality were 61%, 68%, 64%, 66%, 62% and 75% for specimen quality, staining quality, smear size, smear thickness, smear evenness and smear cleanliness respectively. Of the total error (0.48%) reported, 0.25%, 0.19% and 0.085% were false positive, false negative and quantification errors respectively. The concordance rate of health facilities for smear reading was increased to 90% by the end of 2018. Overall, the sensitivity, specificity, PPV, and NPV of the smear readings were 95%, 99.7%, 93% and 99.8% respectively. Likewise, the smear reading agreement was also perfect with kappa value, 0.87.

Drinking water from hand-pump-fitted borehole sources is considered as safe and suitable for human use due to a purification property of the soil. However, the water from these sources can be contaminated as a result of inadequate treatment and waste disposal from humans and livestock.This study aimed to determine the bacterial contamination level of drinking water from hand-pumpfitted borehole sources, the associated risk factor and its antimicrobial susceptibility pattern.Seventy-five hand-pump-fitted boreholes were selected randomly. Total coliforms and Escherichia coli count from water samples were performed using membrane filtration technique. MacConkey agar media was used for both samples and isolates were identified by standard microbiological methods. Antimicrobial susceptibility testing was carried out against seven antibiotics. About 11 (15%) hand-pump-fitted boreholes drinking water and 32 (42.6%) of swab samples showed culture positive. The colony counts for total coliforms and E. coli from water samples were 20-140 CFU/100 mL and 40-80 CFU/100 mL, respectively. E. coli, Enterobacter, Klebsiella, Citrobacter, Salmonella, and Pseudomonas sp. were the predominant isolated bacteria. E. coli and Salmonella sp.were found to be sensitive to all antibiotics and high level resistance was revealed by Klebsiella sp.