Desalu Olufemi O, Ojuawo Olutobi B, Aladesanmi Adeniyi O, Adeoti Adekunle O, Opeyemi Christopher M, Oloyede Taofeek, Afolayan Oluwafemi J, Fawibe Ademola E
Department of Medicine University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
Department of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.
Int J Gen Med. 2022 May 27;15:5285-5296. doi: 10.2147/IJGM.S363326. eCollection 2022.
The burdens of chronic cough are mostly reported from Western and Asian countries. We aimed to determine the etiology and clinical patterns of chronic cough (CC) in the chest clinic of a tertiary hospital in Nigeria.
This survey was a cross-sectional study of 218 patients. Chronic cough was defined as cough >8 weeks duration. The evaluation and diagnosis of patients was based on a diagnostic protocol developed from the international respiratory societies cough guidelines and a previous study.
The median age of patients was 50 years (interquartile range 30-68). One etiology was identified in 96.3% of cases; dual etiologies in 2.3%, and 1.4% had an unexplained cough. The most frequent causes of cough were COPD (33.5%), PTB (27.1%), and asthma (21.1%) which included 3 cases of cough variants of asthma (CVA). Other causes were post-tuberculosis lung disease (bronchiectasis and fibrosis) in 6.9%, lung cancer in 4.7%, and interstitial lung disease (ILD) in 3.2%. Gastroesophageal-related cough (GERC) accounted for <1.0%. Before the age of 45, the chronic cough was more frequent in the females than in the males, and the commonest cause was asthma, whereas, beyond age ≥ 45, the occurrence in males surpasses that of the females, and the commonest cause was COPD. Eighty-six percent reported shortness of breath as the most associated symptom. Systemic hypertension (15.6%) was the most frequent comorbidity, followed by HIV infection (3.7%). Chest radiograph, sputum GeneXpert MTB/RIF for TB, spirometry, and detailed history and trial of treatment, were enough to identify the cause in 72% of cases.
The etiology and clinical patterns of chronic cough in this study are different from the western countries. When evaluating and managing chronic cough, clinicians in sub-Saharan Africa and TB endemic countries should consider these geographical variations in etiologies and clinical presentation.
慢性咳嗽的负担大多来自西方国家和亚洲国家。我们旨在确定尼日利亚一家三级医院胸部门诊慢性咳嗽（CC）的病因及临床模式。
本调查是一项对218例患者的横断面研究。慢性咳嗽定义为咳嗽持续时间>8周。患者的评估与诊断基于从国际呼吸学会咳嗽指南及一项既往研究制定的诊断方案。
患者的中位年龄为50岁（四分位间距30 - 68岁）。96.3%的病例确定了一种病因；2.3%为双重病因，1.4%有不明原因咳嗽。咳嗽最常见的病因是慢性阻塞性肺疾病（COPD，33.5%）、肺结核（PTB，27.1%）和哮喘（21.1%），其中包括3例咳嗽变异性哮喘（CVA）。其他病因包括结核后肺部疾病（支气管扩张和纤维化，6.9%）、肺癌（4.7%）和间质性肺疾病（ILD，3.2%）。胃食管相关咳嗽（GERC）占比<1.0%。45岁之前，女性慢性咳嗽比男性更常见，最常见病因是哮喘，而45岁及以上，男性发病率超过女性，最常见病因是COPD。86%的患者报告气短是最相关症状。系统性高血压（15.6%）是最常见的合并症，其次是HIV感染（3.7%）。胸部X线片、痰结核分枝杆菌/利福平基因检测、肺功能测定以及详细病史和治疗试验，足以在72%的病例中确定病因。
本研究中慢性咳嗽的病因及临床模式与西方国家不同。在评估和管理慢性咳嗽时，撒哈拉以南非洲和结核病流行国家的临床医生应考虑这些病因和临床表现的地理差异。
