IMPACT OF COMORBIDITY ON CLINICAL PRESENTATION AND OUTCOME OF PULMONARY TUBERCULOSIS

Abstract

SUMMARY A cross the world tuberculosis (TB) remains an important public health problem, especially in developing countries. One third of the world’s population is infected with Mycobacterium tuberculosis and every year almost 2 million people die from TB, most of them in low- and middle-income countries. The comorbid diseases associated with pulmonary tuberculosis is considered as risk factors for TB progression from infection to disease due to negative impact on host defense mechanisms and it complicate outcome of TB. The study aims to determine prospectively the clinical presentation and outcome of comorbid diseases associated with TB. Ninety patients were admitted to Abbassia Chest Hospital at February 2014 (group1 included 49 patients, and group2 included 41patients),they all investigated for TB and associated comorbidity, and they are followed up till September 2014. The study revealed that males outnumbered females with mean age in patient group was about 34.76±13.97, and the control group was 29.96±12.06. DM was the most frequent comorbidity seen in the study, it accounts for 30% of other comorbid diseases. The most frequent poor outcome was treatment failure occurred in group2 having comorbidity, more than group1; it was 24.39% and 10.20% respectively. 48.78% of Group 2 wassuccessfully treated while 71.43% in group 1. Defaulter, Relapse and transfer not presented in outcome of this study. Regarding ICU admission it was 19.51% among group2, and 6.12%among group1. There were only 3 patients escaped the follow up among group2, and 6 among group 1. There was a significant difference between group2 and group1 regarding special habits, clinical and, radiological presentations, and change in treatment regimen. It was found in this study that HIVand renal failure were also significantly affect the outcome of TB and ICU admitted patients were died due to respiratory failure.