Features Of Pulmonary Tuberculosis Research Articles

The Atypical Manifestation of Pulmonary Tuberculosis in Patients with Bronchial Anthracofibrosis.

It has been stated that bronchial anthracofibrosis (BAF) has an important relationship with pulmonary tuberculosis (TB), and the coexistence of TB and BAF is high. The purpose of this study was to compare the differences in computed tomography (CT) characteristics of pulmonary TB according to the presence of underlying BAF. Total of 202 consecutive patients who were diagnosed with pulmonary TB and underwent bronchoscopy and CT in our institution were retrospectively reviewed. We classified the patients into two groups according to the presence of BAF and compared the clinicoradiological findings between the two groups (anthracofibrosis group vs. nonanthracofibrosis group). Elderly and female patients were significantly higher in anthracofibrosis group (mean age 79 ± 7 (64–94) vs. 56 ± 17 (16–95), p < 0.001; female 89% vs. 29%, p < 0.001). The frequency of internal low-density area or focal contour bulge within atelectasis (64% vs. 1%, p < 0.001), lower lobe predominance (43% vs. 9%, p < 0.001), endobronchial involvement (46% vs. 15%, p < 0.001), and lymphadenopathy (57% vs. 28%, p = 0.002) were significantly higher in anthracofibrosis group. In contrast, the anthracofibrosis group showed lower frequency of upper lobe predominance (32% vs. 81%, p < 0.001) and cavitation (14% vs. 51%, p = 0.001). In conclusion, being aware of these atypical manifestations of pulmonary TB in the presence of BAF will be of great help in early detection of TB.

Lightweight YOLOv4 with Multiple Receptive Fields for Detection of Pulmonary Tuberculosis.

The characteristics of pulmonary tuberculosis are complex, and the cost of manual screening is high. The detection model based on convolutional neural network is an essential method for assisted diagnosis with artificial intelligence. However, it also has the disadvantages of complex structure and a large number of parameters, and the detection accuracy needs to be further improved. Therefore, an improved lightweight YOLOv4 pulmonary tuberculosis detection model named MIP-MY is proposed. Firstly, over 300 actual cases are selected to make a common dataset by professional physicians, which is used to evaluate the performance of the model. Subsequently, by introducing the inverted residual channel attention and the pyramid pooling module, a new structure of MIP is created and used as the backbone extractor of MIP-MY, which could further decrease the number of parameters and fuse context information. Then the multiple receptive field module is added after the three effective feature layers of the backbone extractor, which effectively enhances the information extraction ability of the deep feature layer and reduces the miss detection rate of small pulmonary tuberculosis lesions. Finally, the pulmonary tuberculosis detection model MIP-MY with lightweight and multiple receptive field characteristics is constructed by combining each improved modules with multiscale structure. Compared to the original YOLOv4, the model parameters of MIP-MY is reduced by 47%, while the mAP value is raised to 95.32% and the miss detection rate is decreased to 6%. It is verified that the model can effectively assist radiologists in the diagnosis of pulmonary tuberculosis.

Chest Imaging for Pulmonary TB-An Update.

The diagnosis of pulmonary tuberculosis (PTB) in children is challenging. Difficulties in acquiring suitable specimens, pauci-bacillary load, and limitations of current diagnostic methods often make microbiological confirmation difficult. Chest imaging provides an additional diagnostic modality that is frequently used in clinical practice. Chest imaging can also provide insight into treatment response and identify development of disease complications. Despite widespread use, chest radiographs are usually non-specific and have high inter- and intra-observer variability. Other diagnostic imaging modalities such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) can provide additional information to substantiate diagnosis. In this review, we discuss the radiological features of PTB in each modality, highlighting the advantages and limitations of each. We also address newer imaging technologies and potential use.

Acute Phase Proteins Are Baseline Predictors of Tuberculosis Treatment Failure.

Systemic inflammation is a characteristic feature of pulmonary tuberculosis (PTB). Whether systemic inflammation is associated with treatment failure in PTB is not known. Participants, who were newly diagnosed, sputum smear and culture positive individuals with drug-sensitive PTB, were treated with standard anti-tuberculosis treatment and classified as having treatment failure or microbiological cure. The plasma levels of acute phase proteins were assessed at baseline (pre-treatment). Baseline levels of C-reactive protein (CRP), alpha-2 macroglobulin (a2M), Haptoglobin and serum amyloid P (SAP) were significantly higher in treatment failure compared to cured individuals. ROC curve analysis demonstrated the utility of these individual markers in discriminating treatment failure from cure. Finally, combined ROC analysis revealed high sensitivity and specificity of 3 marker signatures comprising of CRP, a2M and SAP in distinguishing treatment failure from cured individuals with a sensitivity of 100%, specificity of 100% and area under the curve of 1. Therefore, acute phase proteins are very accurate baseline predictors of PTB treatment failure. If validated in larger cohorts, these markers hold promise for a rapid prognostic testing for adverse treatment outcomes in PTB.

P6‐22: Characteristics of pulmonary tuberculosis with delayed diagnosis in our hospital

P6‐22: Characteristics of pulmonary tuberculosis with delayed diagnosis in our hospital

P6‐19: Clinical characteristics of pulmonary tuberculosis in the central and eastern part of Shizuoka

P6‐19: Clinical characteristics of pulmonary tuberculosis in the central and eastern part of Shizuoka

Vitamin D Deficiency in Tuberculosis and Diabetes Mellitus - A Cluster Analysis

Background: Diabetes mellitus and tuberculosis are a dual disease burden, and diabetes is associated with a threefold risk of developing tuberculosis. Though India is considered to have an abundance of sunlight, the prevalence of deficiency of vitamin D is high, which is shown to cause impairment in the macrophage-initiated immune response against Mycobacterium tuberculosis. Methods: Our study estimated the prevalence of mean levels and determinants of vitamin D deficiency in patients with tuberculosis or diabetes and those with both tuberculosis and diabetes. A cluster analysis was performed to identify whether these patients belong to distinct clusters and evaluate whether vitamin D levels were significantly different between clusters. Results: The study observed that the lowest vitamin D levels were observed among subjects with both pulmonary tuberculosis and diabetes. Multinomial logistic regression analysis observed that higher levels of vitamin D were protective against both diabetes and pulmonary tuberculosis, and while higher body mass index lowered odds of pulmonary tuberculosis, it increased the odds of diabetes. The cluster analysis identified five distinct clusters with different characteristics of pulmonary tuberculosis, diabetes mellitus, sputum mycobacterial load, age distribution, body mass index, vitamin D, serum albumin, and serum calcium. Conclusion: In South India, among patients with pulmonary tuberculosis and diabetes or either disease alone, hypovitaminosis D is a common phenomenon. The cluster analysis plays an important role in future research on biomarkers to identify specific phenotypes in patients with tuberculosis and diabetes.

Clinical-paraclinical characteristics of pulmonary tuberculosis associated with human immunodeficiency virus

Clinical-paraclinical characteristics of pulmonary tuberculosis associated with human immunodeficiency virus. Materials and methods: The analysis of selected scientific publications from the HINARI, MEDLINE, EMBASE, etc. Results and conclusions: in recent years, in the world, tuberculosis associated with the human immunodeficiency virus is one of the most serious public health problems, contributing to the increase in cases of morbidity, incapacity for work and mortality. Usually, the disease develops in young people, with the asocial lifestyle, with compromised immunity, etc. The most common manifestation of tuberculosis in HIV-infected adults is pulmonary. Initially, the tuberculous process affects the upper lungs, where cavities, fibrosis, shrinkage and calcification of the lung can occur. When the immunodeficiency increases, the cough becomes rarer, the intrathoracic lymph nodes become lysed more frequently, and the process already affects the lower lung lobes. To prevent tuberculosis in this contingent of patients it is necessary to dispense them with the necessary examination twice a year, indicating timely antiretroviral therapy and chemoprophylaxis.

Pulmonary Tuberculosis CT-Scan Features and Sputum Smear in Tertiary Referral Hospital

Introduction: Management of pulmonary tuberculosis (PTB) from primary and secondary health centers might affect the result of sputum acid-fast bacilli (AFB) smear and features of lung computed tomography scan (CT-scan) presented in tertiary hospitals. The study aims to investigate comparison between CT-scan features of PTB with sputum AFB smear in Wahidin Sudirohusodo Hospital as the top referral hospital in the Eastern part of Indonesia. Methods: This is a retrospective study of patients diagnosed as PTB by pulmonologist of nine months period. Patients with available CT-scan and sputum AFB smear results are included in the study. CT-scan features re-evaluated with RadiAnt DICOM viewer for standardized reading. The relationship between data obtained was analyzed with a chi-square test. Results: Sixty-one PTB patients were entered into the study. The three most common features found in CT were consolidation (93.4%) followed by Tree-in-bud (91.8%), and fibrosis calcification (85.2%). Relationship of CT features and sputum AFB smear was significant on cavity (p-value: 0.002) and pleural effusion (p-value: 0.020). However, unlike cavity (OR = 1.667), pleural effusion has opposite relationship (OR = 0.205) with sputum AFB smear. Conclusions: Pulmonary tuberculosis CT features seen in top referral hospitals can be very severe with consolidation and tree-in-buds as the most common features found in more than 90% of the cases. Feature of cavity may help radiologist to distinct highly active PTB with positive sputum AFB smear while presence of pleural effusion should raise the suspicion from pulmonologists to add further laboratory investigation.

Peculiarities of pulmonary tuberculosis in a COVID-19 pandemic

Objective. To evaluate the features of pulmonary tuberculosis (TB) in a pandemic of coronavirus disease (COVID-19).&#x0D; Materials and methods. Leading foreign technical sources on the course of TB during the COVID-19 pandemic have been developed.&#x0D; Results and discussion. Respiratory tract infections remain the leading cause of morbidity and mortality from infectious diseases worldwide. The list of World Health Organization (WHO) priority projects for research and development at the end of December 2019 included only three pathogens: coronavirus of the severe acute respiratory syndrome (SARS-CoV), coronavirus of the Middle East respiratory syndrome (MERS-CoV), mycobacterium TB. In January 2020, SARS-CoV-2, which is the cause of COVID-19, was added to the list of priorities. On March 11, 2020, the WHO announced a pandemic of a new dangerous disease – COVID-19. The pandemic has bypassed all other health problems and has become key worldwide and continues to spread, especially in countries with a high burden of TB, including Ukraine. Modern measures for social distancing and staying at home make it difficult to implement a program to provide quality TB care. This can have serious consequences for existing and undiagnosed TB patients worldwide, in particular in low- and middle-income countries where TB is endemic and health services are poorly equipped. It will be important to ensure access to uninterrupted quality care and care for everyone with TB.&#x0D; Conclusions. On average, TB detection in Ukraine decreased by 27.4 %, and the incidence of TB among children decreased by 34.5 %. These are alarming figures, because we know very well that within 6 months the number of TB patients has not decreased, they have simply stopped being diagnosed. Launched cases began to be registered more and more often, and in the conditions of strict quarantine patients – active bacterial isolates pose a threat to contact persons, especially from risk groups according to COVID-19. All of the above is a clear example of the future problem we will deal with in the coming years.

Reliability of chest radiograph interpretation for pulmonary tuberculosis in the screening of childhood TB contacts and migrant children in the UK

To determine interobserver agreement between paediatric radiologists interpreting tuberculosis (TB) screening chest radiographs (CXR) in children in the UK, and the TB detection rate. A retrospective review was undertaken of electronic request, notes, and CXRs (>7 years) in children exposed to an infectious case of TB and new entrants to the UK, at a tertiary children's hospital. Included were those with positive Mantoux/interferon gamma release assay (IGRA), positive culture, or high clinical suspicion of TB. CXR reports were categorised as normal, abnormal without features of TB, or abnormal with features of pulmonary TB. Three paediatric radiologists from a dedicated paediatric radiology department evaluated available CXRs, aware of the TB screening indication, using a published CXR reporting tool and blinded to the initial CXR report and to each other. A majority decision was collated, and considered lymphadenopathy and miliary nodules as diagnostic of primary TB. Interobserver agreement was calculated using Cohen's kappa. One hundred and forty-eight children underwent TB screening with a CXR. One hundred and twenty-five had available CXR reports and case notes, which indicated 20/125 (16%) had CXR features of TB. One hundred and twenty-one of the 125 had CXRs available to for panel review. Twenty of these 121 (17%) yielded a majority decision of pulmonary TB. Inter-reader agreement was moderate in all aspects (kappa 0.4-0.6). The high percentage of pulmonary TB on CXR (16% original reports; 17% by panel review) suggests that it is worthwhile investigating childhood TB contacts; however, the routine use and recommendation for CXR is questionable because of only moderate interpretation reliability (kappa 0.5), even by experts.

Comparison of chest radiographic findings among HIV positive and negative adults with smear positive Pulmonary Tuberculosis in Dar-es-salaam

Background: Chest X-ray radiography is a widely available and cheap imaging modality used for identification of pulmonary tuberculosis (PTB) in suspected patients. Knowledge of discriminatory features of PTB among HIV infected patient is of utmost importance to improve tuberculosis case detection and consequently reduce morbidity and mortality associated with TB among HIV infected individuals. We aimed to describe chest radiographic findings among PTB patients and their association with HIV co-infection and CD4 levels among HIV positive patients.Methodology: A total of 170 newly diagnosed consented smear positive PTB patients underwent postero-anterior Chest radiographs (PA - CXR) and HIV testing. Determination of CD4 count was performed among HIV positive patients. The radiographs were interpreted using glossary of terms for thoracic radiology by two independent radiologists who were blinded to HIV diagnosis.Results: Study participants included 100 (58.9%) males and 70 (41.1%) females. Among these 54 (31.8%) had HIV/PTB co-infection. The pattern of radiographic findings among patients with PTB/HIV compared to PTB only were: pulmonary cavities 44.4% vs 61.2%, (p=0.04), alveolar consolidation 64.9% vs 81.7%, (p=0.04), upper zone consolidation 40.7% vs 57.8%, (p=0.039), middle zone consolidation 25.9% vs 44.8%, (p=0.019) and typical PTB 40.7% vs 57.8%, (p=0.039), respectively. Therefore, lesions were less likely to be observed among PTB/HIV compared to PTB only and the differences were statistically significant. When compared to PTB patients only HIV/PTB co-infected patients had more nodules on the left lung field 85.2% vs 60.9% (p=0.023); on each left lung zone upper 59.3% vs 34.4% (p=0.028); mid 77.8% vs 54.7% (p-value=0.039); lower 66.7% vs 34.4% (p=0.005) and miliary nodules 44.4% vs 15.6% (p=0.003), respectively. HIV/PTB co-infected patients with CD4 &gt; 200 cells/μL had more mid zone consolidation (42.9% vs 15.2%, p=0.024).Conclusion: The commonest chest radiographic findings in HIV/PTB co-infected patients were pulmonary cavities and alveolar consolidation are associated with HIV negative status. HIV/PTB co-infected patients with severe immunosuppression had mid zone consolidation. Patients with severe immunosuppression showed less chest radiographic findings. HIV/PTB co-infection was highly associated with mid and lower zone pulmonary nodules and miliary nodules.&#x0D; Key words: PTB, HIV, CXR

Spatial-temporal analysis of tuberculosis in Chongqing, China 2011-2018

BackgroundChina is a country with a high burden of pulmonary tuberculosis (PTB). Chongqing is in the southwest of China, where the notification rate of PTB ranks tenth in China. This study analyzed the temporal and spatial distribution characteristics of PTB in Chongqing in order to improve TB control measures.MethodsA spatial-temporal analysis has been performed based on the data of PTB from 2011 to 2018, which was extracted from the National Surveillance System. The effect of TB control was measured by variation trend of pathogenic positive PTB notification rate and total TB notification rate. Time series, spatial autonomic correlation and spatial-temporal scanning methods were used to identify the temporal trends and spatial patterns at county level.ResultsA total of 188,528 cases were included in this study. A downward trend was observed in PTB between 2011 and 2018 in Chongqing. The peak of PTB notification occurred in late winter and early spring annually. By calculating the value of Global Moran’s I and Local Getis’s Gi*, we found that PTB was spatially clustered and some significant hot spots were detected in the southeast and northeast of Chongqing. One most likely cluster and three secondary clusters were identified by Kulldorff’s scan spatial-temporal Statistic.ConclusionsThis study identified seasonal patterns and spatial-temporal clusters of PTB cases in Chongqing. Priorities should be given to southeast and northeast of Chongqing for better TB control.

Epidemiological characteristics of pulmonary tuberculosis among health-care workers in Henan, China from 2010 to 2017

BackgroundHealth-care workers (HCWs) are an epidemiological group with increased exposure to tuberculosis (TB), especially at health-care facilities (HCFs) with poor TB infection control in high-TB-burden settings. China is a high-TB-burden country, and the comprehensive measures for stopping TB transmission at some HCFs were not implemented well owing to limited resources and other factors. The purpose of this study was to review risk of occupational exposure to TB among HCWs and its change trend, and identify epidemiological characteristics of pulmonary tuberculosis (PTB) among HCWs in Henan, central part of China.MethodsA retrospective cohort study was conducted from 2010 to 2017. All HCWs and teachers in Henan were enrolled to the study as exposed group and non-exposed control group, respectively. Relative risk (RR), attributable risk (AR) and AR percent (AR%) were used to measure the association between the occupational exposure and PTB, and estimated with Poisson regression.ResultsThe study results showed a total of 1663 cases of PTB were reported among the HCWs in Henan, accounting for 3.2‰ of all PTB cases reported in the whole population, and annual incidence rate of PTB among HCWs declined by 34% from 2010 to 2017. Over the eight years, the incidence rate of PTB among HCWs was 43.7 cases per 100,000 person-years (PYs), significantly higher than that among teachers (18.8 cases/100,000 PYs), and RR, AR and AR% were estimated to 2.3, 24.9 cases per 100,000 PYs and 57%, respectively. Among HCWs, males were more likely to suffer from PTB than females (adjusted RR: 1.3; 95%CI: 1.2–1.4), and HCWs aged under 25 years had the highest relative risk over all age groups with adjusted RR equaling to 8.3 (95%CI: 6.9-9.9) calculated with those aged 45–54 years as the reference.ConclusionsAlthough overall incidence rate of PTB among HCWs showed decreasing temporal trends over the period of 2010–2017, attributable risk of occupational exposure to TB among HCWs did not decrease in Henan, and TB infection at HCFs for males, young or senior HCWs, especially for young HCWs is of much concern.

Chest radiographic findings of pulmonary tuberculosis in human immunodeficiency virus-seropositive patients in a teaching hospital in Kano Northwest, Nigeria

Background: Tuberculosis (TB) is one of the most common infections to occur in the course of human immunodeficiency virus (HIV) infection and remains a global emergency despite substantial investment in health services. Aim: This study aims to determine the spectrum of chest X-ray findings in patients with HIV/TB coinfection. Materials and Methods: A retrospective cross-sectional study of the clinical and radiographic features of pulmonary TB (PTB) in 244 confirmed HIV-seropositive patients aged 9 months to 80 years. Descriptive statistics was employed in analyzing mean percentages and frequencies. Level of statistical significance between clinical findings, radiographic findings, age group, and gender was determined using z-test. Statistical significance was set atP ≤ 0.05. Results: The study constituted of 104 (42.62%) males and 140 (57.38%) females with mean age of 31.62 ± 16.93 years. The major clinical features among HIV-related PTB patients in this study are cough in 56.6% patients, chest pain in 11.44% patients, weight loss in 10.26% patients,P Conclusions: Normal chest X-rays constitute the major findings; primary and postprimary patterns of PTB account for the least findings with the age group 26–38 years as the most occurring (91, 37.30%). Females were more frequently involved in TB coinfection. The preponderance of normal radiographs does not exclude the presence of TB coinfection.

Automatic Detection of Granuloma Necrosis in Pulmonary Tuberculosis Using a Two-Phase Algorithm: 2D-TB.

Granuloma necrosis occurs in hosts susceptible to pathogenic mycobacteria and is a diagnostic visual feature of pulmonary tuberculosis (TB) in humans and in super-susceptible Diversity Outbred (DO) mice infected with Mycobacterium tuberculosis. Currently, no published automated algorithms can detect granuloma necrosis in pulmonary TB. However, such a method could reduce variability, and transform visual patterns into quantitative data for statistical and machine learning analyses. Here, we used histopathological images from super-susceptible DO mice to train, validate, and performance test an algorithm to detect regions of cell-poor necrosis. The algorithm, named 2D-TB, works on 2-dimensional histopathological images in 2 phases. In phase 1, granulomas are detected following background elimination. In phase 2, 2D-TB searches within granulomas for regions of cell-poor necrosis. We used 8 lung sections from 8 different super-susceptible DO mice for training and 10-fold cross validation. We used 13 new lung sections from 10 different super-susceptible DO mice for performance testing. 2D-TB reached 100.0% sensitivity and 91.8% positive prediction value. Compared to an expert pathologist, agreement was 95.5% and there was a statistically significant positive correlation for area detected by 2D-TB and the pathologist. These results show the development, validation, and accurate performance of 2D-TB to detect granuloma necrosis.

Epidemiological characteristics of pulmonary tuberculosis among children in Shandong, China, 2005\u20132017

BackgroundDiagnosis of tuberculosis (TB) in children is challenging. Epidemiological data of childhood pulmonary tuberculosis (PTB) are urgently needed.MethodsWe described trends in epidemiology, clinical characteristics, and treatment outcomes in seven cities of Shandong province, China, during 2005–2017. Data were collected from the China Information System for Disease Control and Prevention.ResultsAmong 6283 (2.4% of all PTB) PTB cases aged < 18 years, 56.5% were male patients, 39.3% were smear-positive and 98.6% were new cases. The overall incidence of childhood PTB declined (7.62 to 3.74 per 100,000) during 2005–2017, with a non-significant change of annual percentage after 2010. While the incidence of smear-positive PTB (6.09 to 0.38 per 100,000 population) decreased significantly, but the incidence of smear-negative PTB (1.52 to 3.36 per 100,000 population) increased significantly during 2005–2017. The overall treatment success occurred among 94.2% childhood PTB. Ten children (0.2%) died.ConclusionThe overall incidence of childhood PTB declined significantly with the disease burden shifting from smear-positive PTB to smear-negative PTB. The discrepancies between notifications and estimations in both TB morbidity and mortality of children need to be addressed urgently.

The epidemic trend and characteristics of tuberculosis for local population and migrants from 2010 to 2017 in Jiading, China

In the present study, we analyze the epidemic trend and characteristics of pulmonary tuberculosis (PTB) registered in the Jiading Industrial Zone, Shanghai from 2010 to 2017, and the information concerning delays in visit to hospital, diagnosis, and treatment. The most important purpose was to reveal the difference in PTB characteristics between local population and migrants. Tuberculosis epidemic data were collected from the National Information System for Disease Control and Prevention (NISDCP) and the specific Jiading system for tuberculosis patients between 2010 and 2017. Descriptive statistics were produced for the epidemic trend and characteristics of PTB cases. The epidemic trend of PTB for migrants was different from the trend for the local population. The peak months for the presentation of migrant TB cases were July, September, and April. The peak months for the presentation of local TB cases were November, July, and April. The two age groups with the greatest percentage of migrant TB cases were 25–34 years and 15–24 years, and the two age groups for the local TB cases with the greatest percentage were ≥ 65 years and 45–54 years. A certain proportion of patients had a delay in visit to hospital (41.00%), delay in diagnosis (26.04%), and delay in treatment (1.38%). Shanghai is a domestic immigration city; a tuberculosis epidemic cannot be ignored. In the current study, local population and migrants have different epidemiological characteristics of tuberculosis. Therefore, different strategies and measures should be adopted for local populations and migrants. In addition, publicity and education concerning early detection and early treatment should be strengthened.

Multivariate analysis of clinical characteristics and prognosis in pulmonary tuberculosis patients complicated with diabetes mellitus

Objective To study and analyze the clinical features of pulmonary tuberculosis complicated with diabetes, and the risk factors affecting the prognosis of pulmonary tuberculosis patients complicated with diabetes by multivariate analysis. Methods From January 2012 to January 2015, 200 tuberculosis patients complicated with diabetes in the Second Hospital of Yuncheng were selected in the research.The clinical data of 200 patients were retrospectively analyzed, the clinical characteristics of pulmonary tuberculosis with diabetes (age, gender, lung cavity etc) were summarized, the 2-year follow-up data were analyzed to analyze the recurrence.The patients were divided into good prognosis group and poor prognosis group.The clinical data were compared between the two groups, multivariate analysis and logistics regression analysis were used to analyze the risk factors affecting prognosis of pulmonary tuberculosis patients with diabetes. Results The distribution of pulmonary tuberculosis patients with diabetes in males was higher than females (P 0.05). The logistics linear regression analysis showed that the effect of blood glucose control, drug resistance and compliance were the risk factors affecting prognosis of pulmonary tuberculosis patients with diabetes. Conclusion Pulmonary tuberculosis complicated with diabetes occurred in elderly male population, the prognosis is often affected by effect of blood glucose control, drug resistance, medication compliance and other factors, clinical intervention should be carried out according to the prognostic risk factors. Key words: Tuberculosis, pulmonary; Diabetes mellitus; Clinical characteristics; Prognosis; Blood glucose; Medication adherence; Intervention studies

Pulmonary Tuberculosis in Morocco: A Two Year Retrospective Study

OBJECTIVES: To determine the epidemiological features of pulmonary tuberculosis in the region of Gharb-Chrarda-Beni-Hssen in Morocco. METHODS: This is a retrospective study of pulmonary tuberculosis cases, diagnosed and treated at the regional diagnostic center of tuberculosis and respiratory diseases (RDCTRD) in Kenitra between January 2010 and December 2011. RESULTS: During the study period, there were 456 cases diagnosed with pulmonary tuberculosis at the RDCTRD, accounting for 51.3% of all tuberculosis cases reported during this period. More than two-thirds were men (69%), with a male-female ratio of 2.22 and 3.3% of cases were children under the age of 15 years. The average age of the patients was 37.07 ± 0.78 years. The average body weight at diagnosis of tuberculosis was 56.20 ± 0.55 kg for all patients. According to the results, 89% of pulmonary tuberculosis cases were microscopically positive. The majority of patients (80.3%) showed signs of tuberculous impregnation. Nearly three-quarters of these cases (71%) were smokers, 21% were cannabis addicts and 7% were alcoholics. Among the 427 cases for whom the outcome was known, 3 (0.7%) of them died. CONCLUSION: Tuberculosis can be controlled by preventing transmission and infection, by stopping the progression from latent infection to active tuberculosis, and by treating active disease.