Demographic characteristics of patients with TB are shown in Table 1. No differences by health departments were found, but PTB presented higher incidence in cities with more than 50 000 inhabitants. In contrast, ETB had higher incidence in villages with less than 5000 inhabitants. In PTB, male/female proportion was higher than in ETB. With respect to age distribution, differences were found (P = 0.041). The 25- to 44-year-old group presented high incidence of PTB and 65 years and more group high incidence of ETB. Mean age was higher in patients with ETB. Pulmonary tuberculosis or ETB was not associated with birthplace; however, PTB incidence was predominant among Eastern Europe patients and ETB among Maghreb patients. Unskilled occupations were the social class more affected (P = .061); it comprises 56.2% of PTB and 48.2% of ETB cases, respectively.
Clinical presentations of ETB were the following: pleural 18 cases (31.5%), lymphatic 17 cases (29.8%), genitourinary 5 cases (8.8%), miliary 5 cases (8.8%), bone and joints 3 cases (5.3%) meningeal-brain 3 cases (5.3%), digestive 3 cases (3.3%), disseminated 1 case (1.8%), lupus erythematosus 1 case (1.8%), and pericardial 1 case (1.8%).
The PTB and ETB are compared with respect to diagnostic tests, antibiotic resistances, and patients' outcome (Table 2). Radiology was positive in 99.3% of PTB and 47.5% of ETB. Pulmonary tuberculosis was confirmed by microbiology in 93.4% of patients, and ETB in only 52.6%. Pathology was positive in 28.1% of patients with ETB, M tuberculosis polymerase chain reaction (PCR) was positive in 28.1% of patients with ETB, and ADA test in 26.3%. Considering all laboratory tests, patients with PTB were positive in 94.9%, and patients with ETB in 78.9%. Isoniazid resistances occurred in 6.6% of patients with PTB and 3.6% of patients with ETB and multiple resistances (isoniazid and rifampicin) in 0.7% of patients with PTB. Two PTB cases were lost to follow-up (1.5%); both patients were immigrants. Cure rate was achieved in 89.7% of patients with PTB and 87.7% of patients with ETB, and deaths by TB were 5.3% in patients with ETB and 0% in patients with PTB. Deaths by other causes were 8.8% in PTB and 7.0% in ETB.
Univariate logistic regression of PTB associated factors compared with ETB is shown in Table 3. Male, lower age, and East Europe birthplace were predominant in PTB, and birthplace in Maghreb countries in ETB. Elevated risks were found of PTB for V-VI social class occupations (OR = 2.82; 95% CI = 1.03-7.70), social problems (OR = 5.86; 95% CI = 2.19-15.64), social marginalization (OR = 4.18; 95% CI = 1.55-11.25), stay in prison (OR = 5.02; 95% CI = 1.14-22.18), and unemployment (OR = 2.82; 95% CI = 1.03-7.70). Higher risk factors of PTB were smoking tobacco (OR = 5.93; 95% CI = 2.82-12.47), alcohol consumption (OR = 9.63; 95% CI = 2.23-41.55), and drug abuse (OR = 10.33; 95% CI = 1.34-77.97). Contact with patients with TB raised the risk of TBP (OR = 2.64; 95% CI = 1.15-6.08). Coexisting pathologies were a risk factor of PTB (OR = 2.49; 95% CI = 1.15-5.35), and alcoholism presented a higher risk with PTB (OR = 13.37; 95% CI = 1.77-101.08). Birthplace in Maghreb countries (OR = 0.56; 95% CI = 0.24-1.29) and positive HIV (OR = 0.55; 95% CI = 0.13-2.52) were inverse factors of PTB but with unstable effect.
Adjusted OR (AOR) of associated factors of PTB is shown in Table 4 and Figures 1 to 6. Higher risk factors of PTB were contact with patients with TB (AOR = 2.51; 95% CI = 1.06-5.95), social problems (AOR = 3.39; 95% CI = 1.05-10.94), and smoking tobacco (AOR = 3.89; 95% CI = 1.66-9.56). Pathologies were a risk factor but with high dispersion (AOR = 2.06; 95% CI = 0.74-5.74). Drug abuse and alcohol consumption were risk factors with lower effect in the adjusted models. An interaction between no-smoking and no-drug abuse was found with AOR = 0.27 (95% CI = 0.12-0.64), and this interaction decreased PTB risk.