Portal de Periódicos da CAPES

Silicosis, tuberculosis time bomb?

2016; Elsevier BV; Linguagem: Inglês

10.1183/13993003.congress-2016.pa2663

1873-281X

Vitor Emanuel Cabral Melo Pereira, Luís Baía, Rita Gaio, Raquel Duarte,

Sarcoidosis and Beryllium Toxicity Research

Setting: Portugal has the highest tuberculosis incidence in Western Europe and in two small northern regions it is more frequently associated with silicosis. Objective: The aim of the present study was to characterize the risk factors associated with silico-tuberculosis and non-silico-tuberculosis patients within the tuberculosis population between 1 January 1999 and 31 December 2012 in Portugal and to identify the possible differences in the diagnosis, treatment and outcome. Design: The study used the surveillance tuberculosis system database and a logistic regression analysis enhanced with boostrapping. Results: In the 13 years studied period, 16581 patients were diagnosed with TB - 205 with silicosis and 16376 without. Almost all (99%) of the silicotic population was male and lived in northern Portugal. When comparing both populations, the silicotuberculosis was more prone to being male (0<0.001), older (p<0.001) and had more frequently pulmonary disease (p<0.001). Treatment completeness was equivalent in both groups but its duration was longer and death was more frequent among silicosis patients (p<0.001). In this group, infection with human immunodeficiency virus (HIV), alcohol or drug abuse was less frequent (p<0.001). SilicoTB had more frequently negative smear sputum results and diagnosis was more frequently done by culture positivity. Conclusion: TB in silicotic patients is more difficult to diagnose and treat, emerging in older groups with no other risk factors for TB. TB awareness must be raised among medical doctors, especially among occupational health services.