Perhimpunan Dokter Paru Indonesia - Risk factors of severe clinical forms of tuberculosis
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Risk factors of severe clinical forms of tuberculosis




Islam Mejri Ep Ajili1, Soumaya Ben Saad1, Achref Ben Tkhayet1, Hafaoua Daghfous1 and Fatma Tritar1
1Pneumology C, Abderrahmen Mami Hospital, Ariana, Tunisia

Globally, efforts are done to control Tuberculosis (TB) as a worldwide health problem.However,severe clinical forms of this disease are still observed especially in burden countries.Our study aims to identify risk factors,clinical presentation,evolution and prognosis of severe TB among immunocompetent patients.It is about a cohort study carried out in our pneumology department . Four hundred (400) cases of TB (2005 -2014) are enrolled. All possible Data are collected.The prevalence of severe cases of TB was 9 % (36 patients): Acute respiratory failure (13 patients),disseminated TB with neurological and miliary forms (13 patients)and death issue (10 patients).These patients were older(46y vs 35;p<0.05),smoker with a higher tobacco consumption(36PA vs 23PA ),malnourished (BMI :16 vs 20),diabetic (13% vs 5.6%;p=0.043),living in rural area (30% vs 11%),illiterate (43% vs 30%), with no BCG vaccine (25% vs 13%;p=0.032) and acute onset of the disease (52% vs 16%;p<0.05).In this group, patients consulted earlier (30 days vs 94 days;p=0.025) with more extrapulmonary symptoms (32% vs 12%;p<0.05),biological abnormalities(anemia: 62% vs 45 and hepatic cytolysis: 5.5% vs 1.2%)and extended radiological lesions(53% vs 27%;p=0.034).There was no difference in confirmation delay and treatment.However, more side effects and complications were observed in severe group: 46% vs 32% and 24% vs 12% respectively. Rapid death was recorded within 10 patients due to respiratory failure (n=7) and fatal hemoptysis (n=3). In survival patients, radiological squeals were frequent 69% vs 32%(p=0.012).Our study shows that TB as a curable disease still can be severe and fatal.To prevent this clinical form, efforts have to be done to detect exposing risk factors.

http://erj.ersjournals.com/content/48/suppl_60/PA2662



PP-PDPI. 12/04/17.



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