Prevalence of TB associated chronic obstructive pulmonary disease in patients with COPD attending at tertiary care hospital in Ahmedabad: A case control study

Abstract

Background: Apart from tobacco smoke, COPD has been known to occur in patients with previous pulmonary TB. Present study was performed with an aim to conduct a study to discover out the hospital based prevalence of TB‑associated COPD among COPD patients and to assess its distinguishing features in Ahmedabad, Gujarat, India. Present study was conducted at the Department of Tuberculosis and Reparatory Medicine, in a tertiary care hospital over a period of 7 months. Seventy-four consecutive patients of stable COPD attending chest OPD were enrolled as cases. An equivalent number of healthy subjects with comparable age and gender distribution were taken as controls. Specific points such as number of anti‑tubercular treatment (ATT) courses, total duration of treatment, time elapsed since completion of treatment and their final outcome were recorded. The prevalence of TB‑associated COPD group was calculated, and its different parameters were compared with rest of COPD patients. Results: Median duration of onset of symptoms was 4.1 years. The unadjusted odds ratio for previous TB in the COPD group in comparison to controls was 3.95. Most of the patients 21/24 had taken a single course of ATT. TB‑associated COPD patients were significantly younger in age as compared to the rest of COPD patients (P ? 0.05) with more proportion of females. On multivariate analysis, duration of dyspnea retained positive correlation with hospitalizations after adjusting for pack years, age, and BMI. Conclusions: TB‑associated COPD constitutes a substantial proportion of COPD in a hospital setting. It is a distinct clinical entity different from a larger smoking related COPD and hence may require different management. Keywords: COPD; Odds ratio; Prevalence; TB.