A Clinical Study on Risk Factors for Recurrent Pulmonary Tuberculosis – a Hospital-Based Study

  • Sabir Cholas Department of T.B and Chest Diseases, Kannur Medical College, Kannur, Kerala, India
  • Iftekhar Ahmed Nazeer Kannur Medical College, Kannur, Kerala, India
Keywords: Isoniazid, Recurrence, Rifampicin, Risk factors, Tuberculosis

Abstract

Aim of the Study: The aim of this study was to understand and identify risk factors in recurrent cases of pulmonary tuberculosis
(TB).
Materials and Methods: A total of 54 patients attending tertiary teaching hospital with recurrent pulmonary TB were included in
this study. Patients who were earlier cured using a four-drug treatment regimen of rifampicin, isoniazid, and pyrazinamide (RHZ)
were included in this study. The risk factors studied were age, gender, race, duration of symptoms, lesion cavitation, extent of
disease, diabetes mellitus (DM), alcoholism, HIV infection, delayed negative sputum conversion, treatment compliance, and
medication doses. To detect recurrence, the patients were monitored for 7.7 ± 2.0 years after cure. Data were analyzed using
the student’s t-test and the Chi-square test.
Observations and Results: A total of 54 patients with symptoms of recurrence of pulmonary TB were included in this study.
The mean age was 38.12 ± 4.60 years. There were 34 (62.96%) males and 21 (38.88%) females. The male-to-female ratio was
1.61:1. The mean age among the males was 40.09 ± 5.62, and it was 34.12 ± 3.75 years. The mean duration of the symptoms
was 82.45 ± 7.15 (12–238) days. There were 19 (35.18%) patients who were chronic alcoholics. The number of patients who
showed cavity in their X-ray lung investigation was 46/54 (85.18%). The noncompliance among the diabetic patients was
2/54 (3.70%) with the total number of patients with DM was 20/54 (37.03%). Among the 54 patients, 31/54 (57.40%) patients
were tested for HIV screening; among them, 07/31 (22.58%) tested positive for HIV. There were 07/31 (22.58%) positive HIV
test patients in the recurrence group, and 09.01% HIV positive incidence in the nonrecurrence group which was statistically
significant (P < 0.05).
Conclusions: Recurrence of TB was more common in HIV-positive patients, and in patients, who did not comply with the selfadministered treatment (RHZ regimen). Patients presenting at least one of these risk factors can benefit from the implementation
of a posttreatment surveillance system for early detection of recurrence. An alternative to prevent noncompliance with TB
treatment would be the use of supervised treatment.

Author Biographies

Sabir Cholas, Department of T.B and Chest Diseases, Kannur Medical College, Kannur, Kerala, India

Associate Professor, 

Iftekhar Ahmed Nazeer, Kannur Medical College, Kannur, Kerala, India

Associate Professor, Department of Pharmacology, 

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Published
2018-05-13