Chronic Respiratory Symptoms and Lung Abnormalities Among People With a History of Tuberculosis in Uganda: A National Survey.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
17 05 2019
Historique:
received: 26 06 2018
accepted: 10 09 2018
pubmed: 22 9 2018
medline: 5 8 2020
entrez: 22 9 2018
Statut: ppublish

Résumé

People with pulmonary tuberculosis are at risk of developing chronic respiratory disorders due to residual lung damage. To date, the scope of the problem in high-burden tuberculosis countries is relatively unknown. Chronic respiratory symptoms (cough and phlegm lasting >2 weeks) and radiological lung abnormalities were compared between adults with and without a history of tuberculosis among the general population of Uganda. Multivariable regression models were used to estimate odds ratios (ORs) with adjustment for age, gender, smoking, education, setting, and region. Random effects models accounted for village clustering effect. Of 45293 invited people from 70 villages, 41154 (90.9%) participated in the survey. A total of 798 had a history of tuberculosis and, among them, 16% had respiratory symptoms and 41% X-ray abnormalities. Adjusted ORs showed strong evidence for individuals with a history of tuberculosis having increased risk of respiratory symptoms (OR, 4.02; 95% confidence interval [CI], 3.25-4.96) and X-ray abnormalities (OR, 17.52; 95% CI, 14.76-20.79), attributing 6% and 24% of the respective population risks. In Uganda, a history of tuberculosis was a strong predictor of respiratory symptoms and lung abnormalities, before older age and smoking. Eliminating tuberculosis disease could reduce the prevalence of chronic respiratory symptoms as much as eliminating smoking.

Sections du résumé

BACKGROUND
People with pulmonary tuberculosis are at risk of developing chronic respiratory disorders due to residual lung damage. To date, the scope of the problem in high-burden tuberculosis countries is relatively unknown.
METHODS
Chronic respiratory symptoms (cough and phlegm lasting >2 weeks) and radiological lung abnormalities were compared between adults with and without a history of tuberculosis among the general population of Uganda. Multivariable regression models were used to estimate odds ratios (ORs) with adjustment for age, gender, smoking, education, setting, and region. Random effects models accounted for village clustering effect.
RESULTS
Of 45293 invited people from 70 villages, 41154 (90.9%) participated in the survey. A total of 798 had a history of tuberculosis and, among them, 16% had respiratory symptoms and 41% X-ray abnormalities. Adjusted ORs showed strong evidence for individuals with a history of tuberculosis having increased risk of respiratory symptoms (OR, 4.02; 95% confidence interval [CI], 3.25-4.96) and X-ray abnormalities (OR, 17.52; 95% CI, 14.76-20.79), attributing 6% and 24% of the respective population risks.
CONCLUSIONS
In Uganda, a history of tuberculosis was a strong predictor of respiratory symptoms and lung abnormalities, before older age and smoking. Eliminating tuberculosis disease could reduce the prevalence of chronic respiratory symptoms as much as eliminating smoking.

Identifiants

pubmed: 30239605
pii: 5099459
doi: 10.1093/cid/ciy795
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1919-1925

Subventions

Organisme : Department of Health
Pays : United Kingdom

Informations de copyright

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Auteurs

Sanne Christine van Kampen (SC)

Clinical Trials and Population Studies Department, University of Plymouth, United Kingdom.

Rupert Jones (R)

Clinical Trials and Population Studies Department, University of Plymouth, United Kingdom.

Harriet Kisembo (H)

Department of Radiology, Mulago Hospital, Kampala, Uganda.

Rein M G J Houben (RMGJ)

Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, United Kingdom.

Yinghui Wei (Y)

Centre for Mathematical Sciences, School of Computing, Electronics and Mathematics, University of Plymouth, United Kingdom.

Frank R Mugabe (FR)

National Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda.

Elizeus Rutebemberwa (E)

Lung Institute, Makerere University, Kampala, Uganda.

Bruce Kirenga (B)

Lung Institute, Makerere University, Kampala, Uganda.

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