Drug abuse: does it change the profile and prognosis of pulmonary tuberculosis?

<bold>Background:</bold> Drug abuse (DA) and pulmonary tuberculosis (PTB) are two major public health concerns that continue to constitute significant challenges worldwide. <bold>Aims:</bold> To assess the clinical profile and prognosis of PTB in drug-abusing patients. <bold>Methods:</bold> A retrospective study including patients with PTB hospitalized in Charles Nicolle Hospital’s pulmonalogy department in Tunis from 2015 to 2023. Two groups were identified : G1: patients with drug abuse and G2: without drug abuse. <bold>Results:</bold> We including 203 patients, of which 30 (15%) were drug addicts. The mean age was 43.8±17.2 years, with a gender ratio of 4.48. Patients in G1 were younger (39.2±14 years vs 44.6±18 years; p=0.01). There was no significant difference in gender between the two groups. Incarceration was more prevalent in G1 (23% vs 11%, p=0.008). Socio-economic conditions were worse in G1 (63% vs 56%; p=0.03). Diabetes was more frequent in G2 (21% vs 3%, p=0.02). Consultation and diagnosis delays were similar in both groups. Cavitary lesions were more frequent in G1 (55% vs 45%, p = 0.05). There was no significant difference in treatment compliance between the two groups. However, G1 patient had worse prognosis (p=0.03), with a longer sputum negativation delay (p = 0.01) and more frequent pneumothorax complication (38% vs 12%, p=0.001). <bold>Conclusions:</bold> In this study, findings agree with literature. Drug-addict patients with pulmonary tuberculosis are younger and have worse prognosis with more complications and longer sputum negativation delay.