Prevalence and patient characteristics associated with pleural tuberculosis in Nigeria

Abstract

Background: Tuberculosis is a leading cause of mortality worldwide, with a growing death rate. The pleural space is a common extrapulmonary site of involvement.

The aim of this paper is to document prevalence and types of pleural involvement in pulmonary tuberculosis and patient characteristics associated with its occurrence.

Methodology:  The study was conducted in a hospital outpatient clinic in which consecutive patients with pulmonary tuberculosis (PTB) or suspects were recruited and studied for the presence of co existing pleural disease or involvement (PD).

Results:  Of 100 patients studied, eighty-two (82%) had PTB alone and six (6%) patients had PD. Pleural effusion was responsible for the majority of the cases, accounting for 67% of PD. There was no case of empyema. Mean age between patients with PTB and PTB/PD was similar.  On univariate analysis, patients with PD had a shorter duration of symptoms and increased reporting of fever (p value = .0.02) and were also different from those with only PTB in HIV seropositivity and sputum smear from AFB (p value = 0.02 and 0.00 respectively).  However, after adjustment for multiple comparisons using the Bonferroni test, the only significant difference between them was in the HIV seropositivity rate (p value < 0.012).

Conclusion:  Less than one tenth of patients with PTB have co-existing and involvement of the pleural space. Pleural involvement is associated with HIV.