U D Kombila1, F B R Mbaye2, Y Dia Kane2, W Ka2, N O Toure Badiane2. 1. Service de médecine interne, centre hospitalier universitaire de Libreville (CHUL), BP 9264, Libreville, Gabon; Service de pneumologie, centre hospitalier national universitaire de FANN (CHNUF), avenue Cheikh-Anta-Diop, BP : 5035, Dakar, Sénégal. Electronic address: ukombila@yahoo.fr. 2. Service de pneumologie, centre hospitalier national universitaire de FANN (CHNUF), avenue Cheikh-Anta-Diop, BP : 5035, Dakar, Sénégal.
Abstract
INTRODUCTION: Tobacco smoke alters lung defense mechanisms against infections and so increases the risk of mycobacterium tuberculosis infection. OBJECTIVE: To determine the particular clinical features of tuberculosis in smokers and identify risk factors. METHODS AND PATIENTS: We conducted a prospective, cross-sectional study over a period of nine months in Dakar, Senegal. The Chi-square test and multiple logistic regression were used to identify differences between smokers and non-smokers and to identify factors associated with clinical outcomes. RESULTS: We included 165 patients with active pulmonary tuberculosis (59 smokers versus 106 never-smokers). The average age of smokers was 43.8±12.7 versus 32.1±13.1 years (P<0.0001). Smokers were overwhelmingly male (98.3% versus 1.8%, P<0.0001). The average delay to consultation was longer among smokers (90 days [30-120] versus 60 days [30-90] ; P<0.0001). In multivariate analysis, alcohol abuse, increasing age, male sex, and an unknown retroviral status were independent risk factors for pulmonary tuberculosis. Haemoptysis was observed more frequently in smokers (49.1% versus 31.1%, P=0.017). With regards to chest X-ray features, smokers presented with more advanced, bilateral and cavitating lung lesions. CONCLUSION: Diagnostic delay and haemoptysis are important characteristics of the pulmonary tuberculosis in tobacco smokers.
INTRODUCTION:Tobacco smoke alters lung defense mechanisms against infections and so increases the risk of mycobacterium tuberculosis infection. OBJECTIVE: To determine the particular clinical features of tuberculosis in smokers and identify risk factors. METHODS AND PATIENTS: We conducted a prospective, cross-sectional study over a period of nine months in Dakar, Senegal. The Chi-square test and multiple logistic regression were used to identify differences between smokers and non-smokers and to identify factors associated with clinical outcomes. RESULTS: We included 165 patients with active pulmonary tuberculosis (59 smokers versus 106 never-smokers). The average age of smokers was 43.8±12.7 versus 32.1±13.1 years (P<0.0001). Smokers were overwhelmingly male (98.3% versus 1.8%, P<0.0001). The average delay to consultation was longer among smokers (90 days [30-120] versus 60 days [30-90] ; P<0.0001). In multivariate analysis, alcohol abuse, increasing age, male sex, and an unknown retroviral status were independent risk factors for pulmonary tuberculosis. Haemoptysis was observed more frequently in smokers (49.1% versus 31.1%, P=0.017). With regards to chest X-ray features, smokers presented with more advanced, bilateral and cavitating lung lesions. CONCLUSION: Diagnostic delay and haemoptysis are important characteristics of the pulmonary tuberculosis in tobacco smokers.
Authors: Bayode Romeo Adegbite; Jean Ronald Edoa; Pacome Achimi Agbo; Jean Claude Dejon-Agobé; Paulin N Essone; Fabrice Lotola-Mougeni; Mirabeau Mbong Ngwese; Arnault Mfoumbi; Chester Mevyann; Micheska Epola; Jeannot Frejus Zinsou; Yabo Josiane Honkpehedji; Selidji Todagbe Agnandji; Peter Gottfried Kremsner; Abraham Sunday Alabi; Ayola Akim Adegnika; Martin Peter Grobusch Journal: Am J Trop Med Hyg Date: 2020-09-17 Impact factor: 3.707