Clinical Presentation and Association among Tuberculosis Patients; Cohort Comparison between Smokers versus Never- Smoke in Penang, Malaysia

We aimed to compare the demographic and clinical characteristics with risk determination of TB patients who were smokers vs. non-smokers. The retrospective, observational & cross-sectional cohort survey was done to compare disease characteristic and clinical presentation during treatment of TB. Cluster random sampling employed in Chest Clinic of Penang General Hospital from January/2006 to June/2008. Statistical test were used with p-value ≤ 0.05 were considered statistically significant at 95% level of confidence interval. A total of 524 TB patients were recruited in study. Of this, 250 (47.7%) were never smokers and rest 274 (52.3%) were under ever-smoker. Majority of patients who had EPTB (79%) were never smoke and majority of patients (62.8%) who had pulmonary with EPTB were ever smokers. Ever smokers TB patients were commonly associated with older age and male gender, they also had higher proportion of risk factors compared to never smokers; high alcohol consumption (61% versus 3%), IVDU (48% versus 2%). There were significant relationships between smoking status of TB patient with race and initial Mantoux test. Ever smokers were significantly more likely to have moderate or far advanced lung’s lesion but less likely to present with minimal lesion on chest X-ray. Ever smokers TB patients were six times more likely to have opacity on chest X-ray compared to never smokers respectively. Smoking association had a significant effect on the severity of clinical, microbiological and radiological presentations resulting in more aggressive course of the disease compared with never smoking patients.