Clinical Trials and Population Studies Department, University of Plymouth, United Kingdom.
Department of Radiology, Mulago Hospital, Kampala, Uganda.
Clin Infect Dis. 2019 May 17;68(11):1919-1925. doi: 10.1093/cid/ciy795.
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.
由于肺部损伤的残留，肺结核患者有发生慢性呼吸系统疾病的风险。迄今为止，高负担结核病国家的问题范围尚不清楚。
在乌干达的普通人群中，比较了有和无结核病史的成年人中慢性呼吸系统症状（持续 >2 周的咳嗽和咳痰）和肺部影像学异常。使用多变量回归模型，调整年龄、性别、吸烟、教育、环境和地区因素后，估计比值比（OR）。随机效应模型考虑了村庄聚类效应。
在来自 70 个村庄的 45293 名受邀者中，有 41154 人（90.9%）参与了调查。共有 798 人有结核病病史，其中 16%有呼吸系统症状，41%有 X 线异常。调整后的 OR 表明，有结核病病史的个体发生呼吸系统症状（OR，4.02；95%置信区间[CI]，3.25-4.96）和 X 线异常（OR，17.52；95% CI，14.76-20.79）的风险明显更高，分别归因于各自人群风险的 6%和 24%。
在乌干达，结核病病史是呼吸系统症状和肺部异常的一个强有力的预测因素，甚至早于年龄和吸烟因素。消除结核病可能会像消除吸烟一样，降低慢性呼吸系统症状的患病率。
