TY - JOUR T1 - The change of tuberculosis features through decades in immune-competent patients JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P1063 AU - Islam Mejri AU - Soumaya Ben Saad AU - Hafaoua Daghfous AU - Mouna Ben Khlifa AU - Hela Cherif Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P1063.abstract N2 - Introduction: Tuberculosis (TB) reemerged as a major health problem. Today, this disease remain endemic all over the world. In common with other countries, Tunisia faces a resurgence of TB.Aim: Overview changes in clinical features and management of TB in Tunisia through decades.Method: There is a comparative study including 3 groups of TB cases registered between 1980-1983(G1: n=522 ), 1990-1993 (G2: n=200) and 2010-2013 (G3: n=100).Results: Mean age was 35 years in all groups. The incidence rate in elderly patients was 10% (G3) vs 2% (G1, 2). Low socio-economic status interested 34% (G3) vs 90% (G1). More than half of cases were smokers. Chronic alcohol consumers were 35% (G3) vs20% (G2) and drug users are 3% (G3) vs0% (G1,2). BCG vaccine was done in 82 % of patients (G3) vs 30% (G1).More than 17% had diabetes (G3) vs13% (G2) vs 7% (G1). Family transmission was 21% (G3) vs 15% (G1). Extra pulmonary symptoms was noted in 16 % (G3) vs 2% (G1).There was more extra pulmonary localization of TB 14 % (G3) vs 4,5% (G1). Thus, severe forms with bilateral localization and lung destruction decreased from 34% (G1) to 13% (G3). Microscopic sputum smear was positive in 67% (G3) vs 73% (G1) with positive culture as well in half of cases .Unfortunately, positive diagnosis was delayed by 10 days (G3) vs 3 days (G1). All patients were treated under DOTS with less success 80% (G3) vs 97% (G1) and more side effects 48% (G3) vs 34% (G1). Consequently, clearing sputum smear was differed to 90 days in 9% (G3) vs 1.5% (G1).Conclusion: There is still a lot to be done to control TB, especially in high burden countries where fast identification and early treatment represents the cornerstone for the best outcomes. ER -