[Pulmonary tuberculosis in smokers].
BACKGROUND
Tobacco smoking and tuberculosis (TB) are two major public health problems, and the former may affect the morbidity and mortality rates for the latter. This study sought to compare the clinical and radiologic aspects of pulmonary TB, as well as outcome, in smokers and nonsmokers.


METHODS
This retrospective case control study examined the files of 90 patients in our pulmonary department with active pulmonary TB, 45 of them smokers and 45, nonsmokers. To analyze the seriousness of the radiologic lesions, we used a score based on the International Labour Organization classification for simple pneumoconiosis, rating lesions in 4 grades according to severity and extent.


RESULTS
The mean age of the patients, all men, was 29 years (range: 16-50 years). Symptoms were similar in both groups, with no significant clinical or bacteriological differences between the two groups. However, the highest severity score was found in 81% of the smoking group compared with 15% of the nonsmokers (p<0.001). Moreover, after patients were cured, only smokers had severe radiological sequelae (13.8% versus 0%, p<0.05).


CONCLUSIONS
Our study is one of the few to compare the radiological appearance of TB in smoking and nonsmoking patients. Smoking is associated with much more extensive and severe radiological TB lesions and sequelae and increases the risk of morbidity and mortality in TB patients. Therefore smoking prevention and cessation should be a priority in TB prevention programs.
Racil
Hajer
H
Service de pneumologie pavillon II ; Hôpital Abderrahmen Mami Ariana, Tunisie.
Amar
Jihen Ben
JB
Cheikrouhou
Sana
S
Hassine
Elyes
E
Zarrouk
Mourad
M
Chaouch
Naouel
N
Chabbou
Abdellatif
A
D000293:Adolescent; D000328:Adult; D001500:BCG Vaccine; D002637:Chest Pain / Q000382:microbiology; D003371:Cough / Q000382:microbiology; D005334:Fever / Q000382:microbiology; D006292:Health Priorities; D006469:Hemoptysis / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D014416:Tunisia / Q000453:epidemiology; D015431:Weight Loss
D001500:BCG Vaccine