1
|
[Epidemiological and evolutionary profile of tuberculosis under the influence og HIV]. Rev Mal Respir 2021; 39:1-7. [PMID: 34756503 DOI: 10.1016/j.rmr.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 09/05/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We conducted this study to understand the impact of HIV infection on the epidemiology of tuberculosis (TB) in an outpatient care center. PATIENTS AND METHODS This is a retrospective and comparative study between subjects infected or not infected with HIV, using TB case notification data registered from October 2017 to September 2019 in the intermediate care facility (CDT) of the University Hospital of Libreville. Comparisons were made by bivariate analysis; proportions were compared using the Chi2 or the Fisher Exact test. Variables of significant interest were included in a binary logistic regression model for multivariate analysis. RESULTS Prevalence of HIV infection was 30.4%. Average age was 35.2 years with extremes at 15 and 83 years. In the results of the multivariate analysis, female patients were more frequently infected with HIV (p=0.002; OR=1.960, 95% CI [1.275 - 3.015]) and HIV infection was associated with a reduction in the proportion of PTB (+) (p=0.001; OR=0.483, 95% CI [0.311 - 0.752]). HIV infection was also associated with an increased proportion of new cases (P=0.007; OR=2.987, 95% CI [1.353 - 6.597]), EPT (p<0.001; OR=1.084, 95% CI [1.054 - 1.131] and an unfavorable therapeutic outcome (p=0.016; OR=2.744, 95% CI [1.208 - 6.233]). CONCLUSION TB/HIV co-infection remains high. It continues to negatively impact outpatient management of TB.
Collapse
|
2
|
Moussa N, Kacem JH, Gargouri R, Kallel N, Kammoun S. Clinico-radiological particularities of common pulmonary tuberculosis among smokers in Tunisia. LA TUNISIE MEDICALE 2021; 99:638-643. [PMID: 35244916 PMCID: PMC8795993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
INRODUCTION Smoking and tuberculosis are two major public health issues worldwide, particularly in emerging countries. Currently, the relationship between these two scourges is well established. AIM Describe the clinical, radiological and progressive features of common pulmonary tuberculosis in smokers. METHODS Comparative study, carried out at the Pneumology department of the Hédi Chaker in Sfax, Tunisia, including 120 patients hospitalized for common pulmonary tuberculosis from January 2014 to December 2016 and who completed their follow-ups for a minimum period of 2 years . The patients were divided into 2 groups: Group1 (G1) consisting of 60 smoking patients and Group 2 (G2) consisting of 60 non-smoking patients. To assess the severity of radiological lesions, we used the International Labour Organization classification for simple pneumoconiosis and the Brouet classification. RESULTS The mean age of the patients was comparable in the two groups with a predominance of male for G1 (91%) and female for G2 (70%). The smokers consulted later (113 days versus 60 days (p=0.023). Dyspnea, hemoptysis and chest pain were significantly more frequent in the smokers. The radiological lesions were more serious in smoking group. Bilateral lesions were more observed in smokers (58% vs 25% p = 0.004). A positive association was noted between the extent of radiological lesions, stage 3 and 4 according to the Brouet classification, and smoking status (p <0.001). Similarly for the International Labour Organization classification for simple pneumoconiosis , the radiological lesions were more severe (scores 6 - 15) in the smokers (p <0.001).Smoking was associated with poor adherence (p <0.008), prolonged anti-tuberculosis treatment (p <0.001), delayed RBK negativation in sputum (p <0.001), and more frequent reactivation of tuberculosis (p=0.001). After the diagnosis of CPT, 83% of patients continued to smoke at the same rate and only 7% of patients had quit smoking. CONCLUSION Smoking worsens CPT by making the clinical picture noisier, radiological lesions more aggressive, negativation of BK in sputum later, and reactivation of CPT more frequent.
Collapse
Affiliation(s)
- Nadia Moussa
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Jihene Haj Kacem
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Rahma Gargouri
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Nessrine Kallel
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| | - Samy Kammoun
- 1. Service de pneumologie CHU Hédi Chaker Sfax / université de Sfax
| |
Collapse
|
3
|
Adegbite BR, Edoa JR, Achimi Agbo P, Dejon-Agobé JC, N Essone P, Lotola-Mougeni F, Mbong Ngwese M, Mfoumbi A, Mevyann C, Epola M, Zinsou JF, Honkpehedji YJ, Agnandji ST, Kremsner PG, Alabi AS, Adegnika AA, Grobusch MP. Epidemiological, Mycobacteriological, and Clinical Characteristics of Smoking Pulmonary Tuberculosis Patients, in Lambaréné, Gabon: A Cross-Sectional Study. Am J Trop Med Hyg 2020; 103:2501-2505. [PMID: 32975178 DOI: 10.4269/ajtmh.20-0424] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gabon carries a high burden of both tuberculosis (TB) and smoking. This study examines the disease characteristics of smoking pulmonary TB patients in Lambaréné. We interviewed adult pulmonary TB patients in Lambaréné, between March 2016 and April 2019. Clinical and biological patient characteristics were collected. Bivariate and logistic regression analyses were performed to assess factors associated with smoking. The mean age of patients included was 31 years (±13). The proportion of smokers in our study was 30% (89/295). Smoking was significantly associated with patient-related diagnostic delay (adjusted odds ratio [AOR] = 8.18; 95% CI = 3.67-19.56), a higher number of pulmonary TB signs and symptoms (AOR = 2.74; 95% CI = 1.18-6.73), and a higher sputum mycobacterial load (AOR = 3.18; 95% CI = 1.33-8.11). The prevalence of smoking among TB patients is high, and leading to aggravated disease as compared with controls. Our study findings suggest that smoking patients should be regularly screened for TB, to reduce diagnostic delay and TB transmission within community. Smoking cessation activities should be included in the national TB control program in Gabon.
Collapse
Affiliation(s)
- Bayode Romeo Adegbite
- Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands.,Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jean Ronald Edoa
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Pacome Achimi Agbo
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jean Claude Dejon-Agobé
- Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands.,Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Paulin N Essone
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Fabrice Lotola-Mougeni
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Mirabeau Mbong Ngwese
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Arnault Mfoumbi
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Chester Mevyann
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Micheska Epola
- Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jeannot Frejus Zinsou
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Yabo Josiane Honkpehedji
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Selidji Todagbe Agnandji
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Peter Gottfried Kremsner
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Abraham Sunday Alabi
- Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Ayola Akim Adegnika
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Martin Peter Grobusch
- Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Centre de Recherches Médicales de Lambaréné and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen and German Center for Infection Research, Tübingen, Germany.,Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|