Magnitude, risk factors and clinical features of non-cystic fibrosis bronchiectasis in patients at Tikur Anbessa specialized hospital(TASH), Addis Ababa, Ethiopia

Abstract

Background: The global prevalence of non-cystic bronchiectasis is estimated to be 1.5-17.8 cases per 100,000 population and is influenced by diagnostic capability with high-resolution computerized tomography and treatment availability. The disease is associated with significant morbidity and mortality and prevalence, clinical features, and risk factors are unknown in Ethiopia.

Objective: to assess the clinical, laboratory, and radiological features of Bronchiectasis.

Design: Cross-sectional

Setting: Tertiary hospital

Materials and Methods: Data on demographics, respiratory symptoms, physical findings, Chest X-ray and HRCT radiology, and sputum culture were interviewed and extracted from clinic records. The standardized HRCT criteria for the diagnosis of bronchiectasis included Broncho arterial ratio> 1, lack of bronchial tapering, and airway visibility within a centimetre from the visceral pleura.

Results: During the study period, 1200 clinic patients were visited, with 128 (10.67%) of them having bronchiectasis. The mean (SD) age and median duration of illness before diagnosis were 41.26 (15.46) years and 18 months (IQR 4.0-60.0) respectively. The majority of patients presented with cough (n=109, 85.2%). Inspiratory crackles were the most common physical finding (n=74, 54.7%). High resolution computerized tomography showed multilobar involvement in 39.8% patients, the left upper lobe (n=52, 40.6%) and right upper lobe (n=41,32.0%). A majority reported prior respiratory infections (n=108, 84.3%).

Conclusion: Non-Cystic fibrosis bronchiectasis was common in TASH, usually symptomatic, often resulting from prior respiratory infections, and associated with diffuse HRCT findings. Recommendation: Early recognition and treatment of infections may help prevent non-cystic fibrosis bronchiectasis and decreases morbidity and mortality.