Predictors of pulmonary tuberculosis relapse

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Introduction: Tuberculosis relapse is defined according to the national tuberculosis control program as any case of tuberculosis previously treated and declared cured or treatment completed after a sufficient duration of treatment and which again presents with active tuberculosis. The aim of our work is to study the evolutionary profile of tuberculosis patients and to study the predictive factors of relapse. Methods: This was a retrospective study including 113 patients followed for confirmed pulmonary tuberculosis. Results: the mean age was 41.5 years ±18.9 with a sex ratio of 3.03. Smoking was present in 69 patients, alcoholism (35%), cannabis consumption (13%). Tuberculosis contagion was found in 22.1% of patients. The positive diagnosis was made by bacteriological evidence in 70.8% of patients and by histological evidence in 19.5%. The cure rate was 78.7% versus a relapse rate of 9% (n=11), 12 patients were lost to follow-up and one patient died. The time to relapse was 6.86 months ±1.7. Therapeutic compliance was present in 62.8%. The predictive factors of relapse were: male gender (p=0.01), alcoholism (p=0.01), poor therapeutic compliance (p=0.03) and tuberculosis contagion (p=0.045). Conclusion: Tuberculosis relapse remains a public health problem in Tunisia, with a high risk of developing multidrug-resistant tuberculosis.

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