Abstract
BackgroundMiliary tuberculosis (MT) is a severe rare form of tuberculosis (TB). It is often due to lymphohaematogenous dissemination of tubercle bacilli. Although the global incidence of TB has been slowly decreasing with globally conducted program, MT incidence is relatively increasing owing mainly to widespread use of immunosuppressive drugs and HIV/AIDS pandemicity. Few reports were found regarding epidemiological data of MT in developing countries. We aim to evaluate epidemiological characteristics of MT in the region of Sfax Southern Tunisia.MethodsWe conducted a retrospective study of all new cases of MT of all ages between January 1995 and December 2016. Data were collected from the regional register of tuberculosis implanted in the anti-tuberculosis center of Sfax.ResultsWe analyzed 22 patients with MT accounting for 0.8 of all cases of tuberculosis. Incidence rates of MT were stable over the 22-year study period. Their median age was of 41 years (IQR= [17–63.5]) and a half of them were females. MT was significantly more common in patients less than 15 years (2.4% vs. 0.7%; OR=3.5; P = 0.04). Six patients (27.3%) had extra-pulmonary locations with lymph nodes (n = 1), meninges (n = 2), bones and joints (n = 1), abdominal cavity (n = 1), and pleura (n = 1). One patient (4.5%) died within 8 months after a confirmed diagnosis. Median duration of treatment was 10 months (IQR = [6–15 months]). The outcome was favorable in 19 cases (86.4%) and three patients received a combined-drug regimen (13.6%).ConclusionMT remains a serious form of tuberculosis which may compromise the life-threatening. It was mainly seen in young nonvaccinated children but currently, except among HIV-infected persons, it is more common among older persons who experience more an endogenous reactivation. These findings emphasize the high efficacy of BCG vaccination in developing countries to prevent MT.Disclosures All authors: No reported disclosures.
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