Changing Pattern of Tuberculosis: Clinical Presentation Within a Decade - Analysis from South-East Europe

Introduction: Tuberculosis (TB) is an infectious disease from which people suffer even in the 21st Century. According to official data for Croatia, the number of cases in the last decade has been decreasing. Aim: Due to the triple reduction in incidence in the last ten years in Croatia, the purpose of this study is to investigate whether patient characteristics have been changed, along with their comorbidities. Material and Methods: This was a cross-sectional study where we treated 230 patients (62.1% male and 37.8% female) age 40-60 years with tuberculosis in 2003 and in 2013, we treated 70 patients (54.9% of men and 45% women). Tuberculosis was diagnosed by direct microscopy of sputum, catheter aspirate, tumor tissue, lymph node puncture, swab wound in 2003 and by direct microscopy of sputum samples, catheter aspirates and bronchial washing samples in 50% of cases in 2013. Results: In 2003, 95.2% of patients had pulmonary tuberculosis. Comorbidities were found in 63.8%. 51.3% were smokers, 36.5% were alcoholics, diabetes and chronic obstructive pulmonary disease (COPD) was found in 12.2% and tumors in 6.5%. After 10 years, 91.4% of patients had pulmonary tuberculosis. 90% of them had comorbidities - 14.2% of patients had diabetes mellitus, 10% were treated for malignancies, COPD was present in 8.5%. 31.4% were smokers, while alcoholism was found in 11.4%. Conclusion: After 10 years tuberculosis has changed its face in South-East Europe. TB occurs more often in the elderly population with comorbidities in 90% of cases (mostly diabetes mellitus, malignancies and COPD). Men are no longer a risk group because women are affected almost equally. Clinical awareness of the possibility of TB should be considered in patients with comorbidities, and active screening and prevention should be undertaken