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The Reported Cases of Tuberculosis in Qaemshahr (2010-2017)

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The Reported Cases of Tuberculosis in Qaemshahr (2010-2017) ORIGINAL: Epidemiological, Clinical and Paraclinical Study of the Reported Cases of Tuberculosis in Qaemshahr (2010-2017) Farhang Babamahmoodi Professor of Infectious Disease, Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Alireza Razavi Medical Student, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Amirhossein Hessami Medical Student, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Foroogh Heydari Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Mohsen Hosseinzadegan Medical Student, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Narges Najafi Associate Professor of Infectious Disease, Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Eissa Soleymani Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran. Lotfollah Davoodi Assistant Professor of Infectious Disease, Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran. ARTICLE INFO ABSTRACT Submitted: 12 Oct 2019 Introduction: Tuberculosis (TB) is a chronic, life-threatening, Accepted: 31 Jan 2020 and contagious infectious. This study aimed to evaluate the Published: 31 Mar 2020 epidemiological, clinical, and paraclinical findings of TB in Keywords: Qaemshahr. Tuberculosis; Material and Methods: In this descriptive cross-sectional study, Epidemiology; we investigated all patients with TB who had registered and Qaemshahr existing data from 2010 to 2017. Demographical data, clinical Correspondence: and paraclinical characteristics including family history of Lotfollah Davoodi, Assistant disease, disease type (pulmonary and extrapulmonary), smear Professor of Infectious Disease, and culture results, underlying disease, chest X-ray results were Department of Infectious Diseases, extracted from records. Data were collected and analyzed using School of Medicine, Antimicrobial SPSS version 22. Resistance Research Center, Mazandaran University of Medical Results: Out of 290 patients, 61.4% were male (178 cases), and Sciences, Sari, Iran. 38.6% (112 cases) were female. The mean age was 21.75 ± 21.25 Email: [email protected] years. 70.7% were pulmonary, and 29.3% were extrapulmonary. ORCID: 0000-0001-7298-7789 60.3% were in urban areas and 39.7% in rural areas. The largest organ involved was lung (70.7%). 95.5% were diagnosed as new. Citation: The smear was negative in 53.8% of patients. 44.8% of patients Babamahmoodi F, Razavi A, were smear-positive. The culture result was positive in 54.5% of Hessami A, Heydari F, patients with TB. In the case of bronchoalveolar lavage (BAL), Hosseinzadegan M, et al. smear, 11.7% of patients had a positive result. The negative result Epidemiological, clinical and of BAL smear was observed in 88.3% of cases. Downloaded from tbsrj.mazums.ac.ir at 21:35 +0330 on Thursday September 30th 2021 [ DOI: 10.18502/tbsrj.v2i1.2581 ] paraclinical study of the reported cases of Tuberculosis in Qaemshahr Conclusion: Awareness of various forms and clinical symptoms, (2010-2017). Tabari Biomed Stu Res radiographic findings in people with TB help to early detection J. 2020;2(1):39-46. of the disease. 10.18502/tbsrj.v2i1.2581 Introduction Tuberculosis (TB) is a life-threatening tuberculosis in most cases. The most common infectious disease that describes a wide range sites of infection are lungs, but it can also of clinical diseases caused by Mycobacterium affect other organs in one-third of cases (1,2). This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/ licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. .Babamahmoodi et al ׀ Epidemiology of TB in Qaemshahr It has been estimated that 10 million people registered and existing data during an 8-year fell ill with TB in 2018, while the incidence period (2010-2017). Demographical data, of TB was 14 per 100,000 in Iran (3). Most clinical and paraclinical characteristics cases of TB are vulnerable populations who including family history of disease, disease are predisposed to risk factors, including type (pulmonary and extrapulmonary), smear population aggregation, unhealthy diet, and culture results, underlying disease, chest weakened immune system, and sources of X-ray results were extracted from records. infection in the family (4). Smoking, alcohol Inclusion criteria were all recognized patients use, and diabetes can also be risk factors for with TB in Qaemshahr from 2010 to 2017, TB infection (5). Transmission of TB occurs and exclusion criteria were patients who had when a source case of TB spread infective incomplete case records. particles that will survive in air and are being Data were collected and analyzed using SPSS inhaled by an individual and may develop TB v.22. In order to investigate association (6). Because of deficiencies in immune between quantitative variables, Pearson’s or system or using immunosuppressive drugs Spearman’s coefficients were calculated, and and other associated factors, 5 to 10 % of Chi-Square test was used for qualitative people who were infected with TB would get variables. P-value < 0.05 was considered as TB disease. If one individual with TB does significant. not get treated, he or she can infect 10 to 15 All relevant authorities and samples were people (7,8). According to disease center of informed of study purposes after obtaining health deputy of ministry of health and permission for research conduction. medical education, TB outbreak is 13% in Participants were also informed that enrolling 1000 in Iran, which reaches its peak in Sistan, in research is mandatory, and they can exit the Baluchestan, and Golestan provinces (9). TB study if they did not want to procced anymore presents with usual clinical and radiological at any time. They were ensured that their presentations includes fever, night sweats, identity would be remained classified in the hemoptysis, and alveolar lesions in upper entire study. Finally, informed consent was lobes in adults and middle-ages. However, obtained from the volunteers. these presentations are not observed in older adults (10). TB diagnosis is usually based on Results observing Acid-fast Bacillus microscopically in sputum or tissue samples. Other diagnostic Of the 290 patients studied, 61.4% were male methods include sample culture, biopsy from (178 patient) and 38.6% (112 patient) female. engaged spot, pathological inspection, and Out of the total population, 60.3% were in observing calcified necrosis and radiology urban areas and 39.7% in rural areas. 70.7% with clinical presentations (11,12). Rapid of patients had pulmonary TB (PTB), and diagnosis and treatment of TB is the best way extrapulmonary TB (EPTB) was present in to prevent it. If TB caused by sensitive 29.3%. The most common organ involved in species being treated correctly, it would be patients with TB was lung (70.7%) followed Downloaded from tbsrj.mazums.ac.ir at 21:35 +0330 on Thursday September 30th 2021 [ DOI: 10.18502/tbsrj.v2i1.2581 ] followed by total recovery, but in the case of by pleural and spine (9.7%) and neck lymph remaining untreated, it would lead to patient nodes (8.6%) (Table 1). Of all patients, mortality in 5 years (1). The purpose of this 95.5% were diagnosed as new. Recurrence study is to investigate epidemiological, had occurred in 2.4% of patients. Four cases clinical, and paraclinical factors of registered were from Sari, Jouybar, Neka, and Kerman. TB disease cases in Qaemshahr between 2010 A total of 290 smears were performed, of to 2017. which 130 were positive. The smear results were negative in 53.8% of patients. The result Methods of cultures was positive in 54.5%. Smear of In this descriptive cross-sectional study, we bronchoalveolar lavage (BAL), 11.8% were investigated all patients with TB who had positive. Negative BAL smear result was 40 Tabari Bio Stu Res J - Volume 2 - Issue 1 .Babamahmoodi et al ׀ Epidemiology of TB in Qaemshahr observed in 88.2% of cases. In 45.9% of chest Diabetes was the most common risk factor radiographs in patients with TB, the result observed among patients with TB (17.2% of was more suggestive of having the disease patients with a history of risk factors for TB). (Table 2). Immunosuppressive medications, low body In total, of the 45 people who tested HIV, weight, prolonged treatment with HIV infection was positive in one patient and corticosteroids, history of TB infection, negative in 44 patients. A history of Intravenous drug user (IVDU), HIV, End imprisonment was the most common risk stage renal disease (ESRD), and malignant factor for HIV in patients with TB (16.6% of hematopoietic and reticuloendothelial 19%). There was also a history of high-risk diseases were risk factors among the patients sexual behavior and a history of injecting with TB in our study. Among the patients, a drug addiction in 1.4% and 1% of patients history of contact with the patient with TB with a history of HIV risk factors, was seen in 15.5% of patients. Most of the respectively. patients who had a history of contact with TB Jaundice and hepatitis were the most common patients had a history of contact in 7.9% over complication of TB (17 cases). Then the past two years, with 18 (6.2%) having vomiting (5 cases), silicosis and itching, skin contact for more than five years (Table 3). rashes were other major complications. The mean length of hospital stay was 11.50 91.7% of people had no specific ±10.98 days. complications (Table 1). Discussion Table 1. Frequency of TB patients in terms of organs involved and major complications About 3 million people die of TB worldwide Variable % (N) each year, of which 98% are in developing Lung 70.7 (205) countries.
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