[Clinical and radiological characteristics of pulmonary tuberculosis in tobacco smokers]

Abstract

Introduction: Tobacco smoke alters lung defense mechanisms against infections and so increases the risk of mycobacterium tuberculosis infection.

Objective: To determine the particular clinical features of tuberculosis in smokers and identify risk factors.

Methods and patients: We conducted a prospective, cross-sectional study over a period of nine months in Dakar, Senegal. The Chi-square test and multiple logistic regression were used to identify differences between smokers and non-smokers and to identify factors associated with clinical outcomes.

Results: We included 165 patients with active pulmonary tuberculosis (59 smokers versus 106 never-smokers). The average age of smokers was 43.8±12.7 versus 32.1±13.1 years (P<0.0001). Smokers were overwhelmingly male (98.3% versus 1.8%, P<0.0001). The average delay to consultation was longer among smokers (90 days [30-120] versus 60 days [30-90] ; P<0.0001). In multivariate analysis, alcohol abuse, increasing age, male sex, and an unknown retroviral status were independent risk factors for pulmonary tuberculosis. Haemoptysis was observed more frequently in smokers (49.1% versus 31.1%, P=0.017). With regards to chest X-ray features, smokers presented with more advanced, bilateral and cavitating lung lesions.

Conclusion: Diagnostic delay and haemoptysis are important characteristics of the pulmonary tuberculosis in tobacco smokers.

Keywords: Dakar; Facteurs de risque; Pulmonary tuberculosis; Risk factors; Smoking; Tabagisme; Tuberculose pulmonaire.