Monthly examination of sputum samples is an important aspect of treatment monitoring for MDR-TB patients. Reviewing the patient’s cultures and smears provides information about the patient’s treatment response, and culture conversion determines the overall duration of MDR treatment, which should continue for a minimum of 18 months after conversion. The World Health Organization offers standardized definitions for MDR-TB treatment outcomes, including culture and smear conversion. However, because the frequency of bacteriological monitoring varies across programs, reporting recommendations are difficult to implement across all settings.
A GHDonline member in Taiwan presented several cases and asked if each patient would be considered to have sputum conversion at 6 months according WHO guidelines. In the dialogue that followed, moderators and members clarified the meaning of “culture conversion at 6 months,” date of sputum conversion and time to conversion, but also shared important distinctions between the use in clinical care versus evaluations of program performance.