Socio-economic, clinical, and behavioral factors associated with study retention among tuberculosis patients in Botswana

Abstract

All study participants provided informed consent. Findings: A total of 1,338 samples collected from 574 TB patients were included in the analysis. Overall, 435 (75.8%) patients had at least one MTB positive culture. Among HIV-infected patients 197/ 278 (70.9%) were culture positive, whereas among HIV-uninfected patients 156/186 (83.9%) were culture positive (p < 0.01). The median time between diagnosis and initiation of culture was four days (interquartile rage 2-6). Among mucopurulent and salivary (clear, mucoid, bloodstained or salivary) samples, 554/738 (75.1%) and 336/548 (61.3%) were culture positive, respectively (p < 0.01). In patients who underwent sputum induction via respiratory methods or gastric aspiration 89/193 (46.1%) were culture positive, while 438/ 596 (73.5%) who voluntarily expectorated sputum were culture positive (p < 0.01). In multivariate analysis, HIV-infection (OR¼0.53 95% CI ¼ 0.32 e 0.88), age (21-30 years vs. Interpretation: We found that age 21-30 years, HIV-infection, and sputum collection method are factors that must be taken into consideration in studies using MTB isolation. Improved methods of MTB culture detection are necessary for HIV co-infected populations and others with low levels of bacilli in the sputum.