768. Epidemiological and Clinical Profile of Miliary Tuberculosis in Southern of Tunisia
Session: Poster Abstract Session: Tuberculosis and Other Mycobacterial Infections
Thursday, October 4, 2018
Room: S Poster Hall
Background:

Miliary tuberculosis (MT) is a severe rare form of tuberculosis (TB). It’s often due to lymphohaematogenous dissemination of tubercle bacilli. Although the global incidence of TB has been slowly decreasing with globally conducted program, MT incidence is relatively increasing owing mainly to widespread use of immunosuppressive drugs and HIV/AIDS pandemicity. Few reports were found regarding epidemiological data of MT in developing countries. We aim to evaluate epidemiological characteristics of MT in the region of Sfax Southern Tunisia.

Methods:

We conducted a retrospective study of all new cases of MT of all ages between January 1995 and December 2016. Data were collected from the regional register of tuberculosis implanted in the anti-tuberculosis center of Sfax.

Results:

We analyzed 22 patients with MT accounting for 0.8 of all cases of tuberculosis. Incidence rates of MT were stable over the 22-year study period. Their median age was of 41 years (IQR= [17-63.5]) and a half of them were females. MT was significantly more common in patients less than 15 years (2.4% vs. 0.7%; OR=3.5; p=0.04). Six patients (27.3%) had extra-pulmonary locations with lymph nodes (n=1), meninges (n=2), bones and joints (n=1), abdominal cavity (n=1), and pleura (n=1). One patient (4.5%) died within 8 months after a confirmed diagnosis. Median duration of treatment was 10 months (IQR= [6-15 months]). The outcome was favorable in 19 cases (86.4%) and 3 patients received a combined-drug regimen (13,6%).

Conclusion:

MT remains a serious form of tuberculosis which may compromise the life-threatening. It was mainly seen in young non-vaccinated children but currently, except among HIV-infected persons, it is more common among older persons who experience more an endogenous reactivation. These findings emphasize the high efficacy of BCG vaccination in developing countries to prevent MT.

Maissa Ben Jemaa, MD1, Makram Koubaa, MD2,3, Houda Ben Ayed, MD1,3, Chakib Marrakchi, MD2,3, Maroua Trigui, MD1, Fatma Hammami, MD2,3, Mariem Ben Hmida, MD1, Tarak Ben Jemaa, MD2,3, Jamel Dammak, MD1 and Mounir Ben Jemaa, MD2,3, (1)Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia, (2)Department of Infectious Diseases, Hedi Chaker University Hospital, Sfax, Tunisia, (3)Extrapulmonary Tuberculosis Research Unit, Hedi Chaker University Hospital, Sfax, Tunisia

Disclosures:

M. Ben Jemaa, None

M. Koubaa, None

H. Ben Ayed, None

C. Marrakchi, None

M. Trigui, None

F. Hammami, None

M. Ben Hmida, None

T. Ben Jemaa, None

J. Dammak, None

M. Ben Jemaa, None

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