Titus G, Hassanali S, Feldman C
Division of Pulmonology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Section of Pulmonology Medicine, Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya.
Afr J Thorac Crit Care Med. 2023 Nov 27;29(4):e1017. doi: 10.7196/AJTCCM.2023.v29i4.1017. eCollection 2023.
Bronchiectasis, once rarely encountered, appears to be increasing in prevalence in South Africa (SA) and globally. There is a lack of published data on non-cystic fibrosis (CF) bronchiectasis, specifically in low- to middle-income countries, despite the high rates of risk factors such as HIV, pulmonary tuberculosis, and other infections.
Given this lack of data, to review the characteristics of adult patients with non-CF bronchiectasis at a tertiary academic hospital in Johannesburg, SA.
This was a single-centre, retrospective record review, including all cases of non-CF bronchiectasis that were in the records of the adult pulmonology clinic at Charlotte Maxeke Johannesburg Academic Hospital as of April 2017.
There were 197 patients, with a slight predominance of males, and the patients were generally young. The HIV rate was higher than the national average (34.8% v. 13.7%), and the HIV-positive patients had a high TB prevalence (86.9%). spp. were cultured from sputum in 15.3% of cases. Fewer than half of the cohort had the diagnosis of bronchiectasis confirmed by high-resolution chest tomography. Airway obstruction (forced expiratory volume in 1 second/forced vital capacity ratio <70%) was observed in 47.0% of patients. Treatment with a short-acting beta-2-agonist was prescribed in 62.9%, a long-acting beta-2-agonist in 43.6% and inhaled corticosteroids in 51.3%. Antibiotic therapy during exacerbations was used in 44.2%, mainly amoxycillin-clavulanate (66.7%).
While single centre and retrospective, this study adds to the data on non-CF bronchiectasis in sub-Saharan Africa and should encourage further research to increase our understanding of adult non-CF bronchiectasis in SA.
This study adds to published data detailing the clinical characteristics of adult non-cystic fibrosis (CF) bronchiectasis in low- and middle-income countries (LMICs). As a retrospective descriptive study, the findings summarise the characteristics of adults with non-CF bronchiectasis in a cohort from Johannesburg, South Africa. The findings suggest that the characteristics of bronchiectasis in this region appear to be similar in several ways to those in other LMICs, but quite different from those in the developed world.
支气管扩张症曾经很少见，但在南非和全球范围内其患病率似乎都在上升。尽管存在诸如艾滋病毒、肺结核和其他感染等高风险因素，但关于非囊性纤维化（CF）支气管扩张症的已发表数据仍然缺乏，尤其是在低收入和中等收入国家。
鉴于缺乏相关数据，本研究旨在回顾南非约翰内斯堡一家三级学术医院中成年非CF支气管扩张症患者的特征。
这是一项单中心回顾性记录研究，纳入了截至2017年4月夏洛特·马克西克约翰内斯堡学术医院成人肺病科记录中的所有非CF支气管扩张症病例。
共有197例患者，男性略占多数，且患者普遍较为年轻。艾滋病毒感染率高于全国平均水平（34.8%对13.7%），艾滋病毒阳性患者的肺结核患病率很高（86.9%）。15.3%的病例痰培养出 菌。不到一半的队列患者通过高分辨率胸部断层扫描确诊为支气管扩张症。47.0%的患者存在气道阻塞（1秒用力呼气容积/用力肺活量比值<70%）。62.9%的患者使用短效β2受体激动剂治疗，43.6%使用长效β2受体激动剂，51.3%使用吸入性糖皮质激素。44.2%的患者在病情加重时使用抗生素治疗，主要是阿莫西林 - 克拉维酸（66.7%）。
尽管本研究为单中心回顾性研究，但它增加了撒哈拉以南非洲非CF支气管扩张症的数据，应鼓励进一步研究以增进我们对南非成年非CF支气管扩张症的了解。
本研究补充了已发表的数据，详细描述了低收入和中等收入国家（LMICs）成年非囊性纤维化（CF）支气管扩张症的临床特征。作为一项回顾性描述性研究，研究结果总结了南非约翰内斯堡队列中成年非CF支气管扩张症患者的特征。研究结果表明，该地区支气管扩张症的特征在某些方面似乎与其他低收入和中等收入国家相似，但与发达国家有很大不同。
