Prevalence and patient characteristics associated with pleural tuberculosis in Nigeria

Olufemi O Adewole,Akinwumi B Ogunrombi,Fehintola A Awopeju,Greg E Erhabor

doi:10.3855/jidc.699

Abstract

Tuberculosis is a leading cause of mortality worldwide, with a growing death rate. The pleural space is a common extrapulmonary site of involvement. The aim of this paper is to document prevalence and types of pleural involvement in pulmonary tuberculosis and patient characteristics associated with its occurrence. The study was conducted in a hospital outpatient clinic in which consecutive patients with pulmonary tuberculosis (PTB) or suspects were recruited and studied for the presence of co existing pleural disease or involvement (PD). Of 100 patients studied, eighty-two (82%) had PTB alone and six (6%) patients had PD. Pleural effusion was responsible for the majority of the cases, accounting for 67% of PD. There was no case of empyema. Mean age between patients with PTB and PTB/PD was similar. On univariate analysis, patients with PD had a shorter duration of symptoms and increased reporting of fever (p value = 0.02) and were also different from those with only PTB in HIV seropositivity and sputum smear from AFB (p value = 0.02 and 0.00 respectively). However, after adjustment for multiple comparisons using the Bonferroni test, the only significant difference between them was in the HIV seropositivity rate (p value < 0.012). Less than one tenth of patients with PTB have co-existing and involvement of the pleural space. Pleural involvement is associated with HIV.

Highlights

Tuberculosis (TB) continues to be a major cause of disability and death
Diagnosis of pulmonary tuberculosis (PTB) was based on the presence of at least two positive smear results, or a negative smear result with radiographic features suggesting PTB and with no improvement after a course of broad spectrum antibiotics with input from a consultant experienced in TB [6]
There was no significant difference in the mean age of the patient groups: 32.2 + 12.8 years versus 36.0 + 13.9 versus 36.6 + 6.0 for the PTB group, PTB and pleural disease or involvement (PD) and EPTTB group respectively (p value = 0.7)

Summary

Introduction

Tuberculosis accounts for 2.5% of the global burden of disease and is the commonest cause of death in young women, accounting for more deaths than all other causes of maternal mortality combined [3]. It is second cause of death worldwide after HIV/AIDS, killing nearly two million people each year [3,4]. Methodology: The study was conducted in a hospital outpatient clinic in which consecutive patients with pulmonary tuberculosis (PTB) or suspects were recruited and studied for the presence of co existing pleural disease or involvement (PD).

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Conclusion