Pulmonary tuberculosis Sequelae: a health problem in the north of Tunisia

Introduction: Tuberculosis (TB) incidence in Tunisia decreased from 48.6/100,000 inhabitants in 1975 to 29/100,000 in 2017. However, TB still a public health problem in the country. Objective: To describe clinical and radiological aspects and outcome of pulmonary tuberculosis Sequelae. Methods: A retrospective descriptive study including hospitalized patients for pulmonary TB Sequelae in pulmonology department of Jendouba hospital. Results: Forty patients were included (24 men). Mean age was 72 years (38 to 91 years). Smoking was noted in 19 cases. A past history of tuberculosis was found in 17 cases . It traces back to 20 years ago on average. The main Discovery circumstances were low respiratory infection (17 cases), productive cough (13 cases) and recurrent hemoptysis (9 cases). Different types of radiological abnormalities were found: heterogeneous retractile opacities (35 cases), pleural thickening (7 cases) and cystic lesions (4 cases). These abnormalities were bilateral in 66% of the cases. Spirometry revealed a severe combined respiratory disorder in the majority of cases. Treatment consisted in antibiotics and bronchial physiotherapy in respiratory infections. Lobectomy and bronchial arterial embolisation were performed in one case respectively. The main complications of pulmonary TB Sequelae were: recurrence of tuberculosis (5 cases), chronic respiratory failure (3 cases), Aspergilloma (1 case) and lung cancer (1 case). Conclusion: Pulmonary TB Sequelae is a health problem in the north of Tunisia particularly in elderly. The national program of TB will reduce the incidence of this disease.