Résumé
Aim: The purpose of this study was to investigate the chest radiographic patterns of smear positive pulmonary tuberculosis patients in relation to HIV co-infection. Study Deign: Cross-sectional descriptive study Place and Duration of the Study: The study was conducted at Gondar University hospital between May 2004–December 2007. Methodology: We studied chest radiographs of 207 (128 HIV negative and 79 HIV positive) consecutive sputum smear positive pulmonary tuberculosis patients according to the standard classification. Mean and percentages/ proportions were used for descriptive analysis. Chi square test was used to measure association. Results: The prevalence of HIV in patients with smear positive pulmonary tuberculosis was 38.2%. The most common chest radiographic patterns were fibronodular (83.1%), cavity (60.4%), lobar consolidation (49.8%), and brochopnemonic consolidation (9.2%). Lymphadenopthy and pleural effusion were more common in HIV co infected patients (p<0.01). Cavities, upper lobe disease and increased mean number of lung lobes involved were more prominent in HIV negative patients (P<0.05). Despite a higher rate of patients with far advanced CXR patterns in HIV negative TBC patients compared to HIV positive (p<0.026), there was no significant difference in the radiographic, sputum smear conversion or clinical response in terms of increased body mass index after 8 weeks of anti TBC treatment between HIV negative and HIV positive patients. Conclusion: Post primary pulmonary tuberculosis was the commonest chest radiographic pattern at presentation in both HIV positive and HIV negative patients, but atypical chest radiographic presentations were associated with co-infection. It was more common for HIV negative tuberculosis patients to have a radiologically far advanced pattern which did not correspond to the clinical and radiological response. This may prompt a need for revision of the current radiological classification.
Résumé
Aim: The main aim of this study was to determine the prevalence of diabetes mellitus in patients with active pulmonary tuberculosis at the University of Gondar Teaching Referral Hospital, northwest Ethiopia. Study Design: A cross-sectional hospital-based study was performed using the WHO structured diabetic assessment protocol. Place and Duration: The study included all active pulmonary tuberculosis patients visiting the University of Gondar Teaching Referral Hospital during the study period (October 2011 to November, 2012). Methodology: We included 199 consecutive active pulmonary tuberculosis patients; 117 of these were male and 108 were urban dwellers. Analyses of fasting blood glucose level were carried out using blood samples collected by finger puncture. For testing significance, categorical data were compared using a chi-square test and expressed as proportion with a 95% confidence interval. Result: The prevalence of diabetes was found to be 8.5 % [95%CI: 4.6– 12.5], which was higher (11.1%) among male than female participants (4.9%). Likewise, 10.2% of the patients were from urban and 6.6% from rural areas. The proportion of newly diagnosed diabetic cases was 52.9%, and all of them were between 25-44 years of age. The Prevalence of impaired fasting glucose was 29.6%. The prevalence of HIV co-infection in the study population was 28.6% [95%CI: 22.3 34.9] and Diabetes was 4 times higher among HIV co-infected patients than among HIV-negative tuberculosis patients. Of all patients with active tuberculosis, 146 (73.7%) were sputum smear negative for acid fast bacilli. The proportion of diabetes was 9.6% among smear positive and 8.2% among smear negative cases. Conclusion: The prevalence of diabetes mellitus and pre-diabetes among active pulmonary tuberculosis cases was higher compared to the published prevalence of DM in the general population. Therefore, it is important to implement an active case detection of diabetes among tuberculosis patients.