Chronic lung disease and a history of tuberculosis (post-tuberculosis lung disease): Clinical features and in-hospital outcomes in a resource-limited setting with a high HIV burden

Background. Many patients with previous pulmonary tuberculosis (PTB) continue to experience respiratory symptoms long after completion of tuberculosis (TB) therapy, often resulting in numerous hospital visits and admissions.Objectives. To describe the profile of patients with chronic lung disease (CLD) with or without a history of PTB, and their in-hospital outcomes. Methods. We conducted a retrospective review of patients with CLD admitted with respiratory symptoms to Dora Nginza Hospital, Port Elizabeth, South Africa, from 1 April 2016 to 31 October 2016. These patients were divided into two groups: CLD with a history of PTB (CLD-TB) and CLD without a history of PTB. Patients with current culture-positive TB were excluded. Baseline characteristics and clinical outcomes (duration of hospitalisation and in-hospital mortality) were compared between the two groups.Results. During the study period, a total of 4 884 patients were admitted and 242 patients received a diagnosis of CLD. In the CLD patient group, 173 had CLD-TB and 69 had no history of PTB. Patients with CLD-TB presented with respiratory symptoms a median of 41 months (interquartile range (IQR) 101) after completion of TB therapy. CLD-TB patients were predominantly male (59.5%), and compared with patients with no history of PTB were more likely to be HIV-positive (49.7% v. 8.7%; p=0.001) and had had more frequent hospital admissions before the current admission (median 2.0 (IQR 2.0) v. 0; p=0.001) and longer hospital stays (median 5 days (IQR 7) v. 2 (4); p=0.002). However, there was no statistically significant difference in in-hospital mortality between the two groups (17.3% v. 10.1%; p=0.165).Conclusions. In patients with CLD, a history of PTB is associated with numerous hospital admissions and longer hospital stays but not with increased in-hospital mortality. TB therefore continues to be a public health burden long after cure of active disease

The History of Tuberculosis in Morocco

Whether TB was already spread in Morocco before the French protectorate or was it brought by foreigners; is an interesting debate in the medical history of Morocco. It was common among practitioners who were first interested in the health situation of Moroccans. TB; and especially its pulmonary form; was rather rare in Morocco [3]. In the 19th century; a medical doctor (Despine) who lived in Essaouira; declared the absence of TB in this Moroccan city; which was open for trade with Europeans very early in history

History of TB in the Sudan

Introduction: Medical history in Sudan is far from being complete. There are no reliable records.Attempt to write on the projects and development of history of TB in the Sudan is a difficult task.Objective:To study and trace the progress of TB in Sudan during the last century through their historical development.Design: A retrospective study.Methods:Data were collected from the annual reports of the Sudan Medical Services.Libraries and a number of previous studies were consulted.Results: The route of entry of TB in the Sudan is mainly from the North.The South was virgin from TB up to 1930s. Northern Sudanese tribes have a high susceptibility and incidence of TB during 1925-1932 (3.7/1000). The south and the Nuba Mountains were almost free from infection or disease. The infectivity rate was highest in North 4.3while Khartoum showed 3. In the South;Rumbek district; no TB cases were reported before the age of puberty up to 1930.Prevalence of tuberculosis in 1959/1960 was 26.0and the detection rate was only 30.Conclusion: Northern Sudanese contracted tuberculosis while serving in the Egyptian army and cities. The Southern and Western tribes who were almost free from TB infection became highly susceptible to both infection and disease. The infectivity rate remains static during the last 50 years