Background:We aimed to evaluate whether neutrophil to lymphocyte ratio (NLR) was associated with relapse occurrence during the follow-up of extra-pulmonary tuberculosis (EPTB). Material and Methods:We retrospectively collected data from 408 EPTB patients hospitalized between 1996 and 2015. We evaluated the performance of NLR in predicting relapse and to stratify patients into high and low level groups. Kaplan-Meier method was used to generate regression-free survival (RFS) curves, which were compared by Logrank test according to NLR categories. Results: Fourteen cases developed a relapse (3.4%). The median value of NLR was significantly higher in patients with relapse (3.8±1.4 vs 2.7±1.4; p=0.008). Receiving operating characteristics (ROC) curves analysis showed that NLR had an Area under the ROC (AUROC) of 0.73 in predicting relapse (p=0.003). At a cut-off of 3, NLR had a sensitivity of 64% and a specificity of 70% to predict relapse. Survival curves showed that patients with a high NLR (≥3) had shorter RFS compared with those with a low NLR (<3) (24.7 vs 44.2 months; p=0.04). High NLR was significantly associated with relapse both in univariate (HR=3.7; p=0.041) and multivariate Cox regression analysis (HR=5.24; p=0.027). Conclusion: NLR may have a prognostic value in the follow up of patients with EPTB.

Background: The aim of this study was to describe the epidemiological profile of childhood respiratory tract diseases (RTD) in the region of Sfax, Tunisia, and to evaluate their trends over a 13 year period. Methods: We conducted a retrospective study of all children hospitalized with RTD aged under 14 years. We collected data from the regional morbidity register of the university hospital of Sfax from 2003 to 2015.Results: A total of 10 797 RTD patients were enrolled from 49 880 pediatric hospitalizations (21.7%). A male predominance was noted (60%). The median age was 8 months (IQR, 2-36 months). Acute bronchitis (AB) accounted for 53.8%, followed by asthma (15%), pneumonia (14%) and acute upper respiratory infection (AURI; 7.2%). The hospital incidence rate (HIR) of RTD was 34/10 000 inhabitants/year. It was 18.2; 5.07; 4.7 and 2.4/10 000 inhabitants for AB, asthma, pneumonia and AURI, respectively. We noted a significant increase in the HIR of RTD with an annual percentage change (APC) of 10.94% (P < 0.001); in the HIR of AB (APC, 5.27%; P < 0.001); and in asthma HIR (APC, 11.2%; P < 0.001). Otherwise, a significant decrease in AURI HIR was observed (APC, -8.8%; P < 0.001). AB lethality rate increased significantly, with an APC of 7.4% (P < 0.001). Projected trends analysis up to 2024 showed a significant rise in AB and in asthma, while AURI would significantly decrease. Conclusions: RTD continues to be a serious health problem over time in terms of morbidity and mortality. Preventive and curative strategies are needed urgently.Key words hospital, pediatric, projection, respiratory tract disease, trend.Respiratory tract diseases (RTD) continue to be a serious health problem worldwide. They confer a significant economic burden with regard to the funding of health resources and disability care loads. Among children, RTD contribute to increase mortality and morbidity. Pediatric hospital morbidity studies allow us to determine the epidemiological profile of a population and to orient interventional strategies accordingly. In Tunisia, as in developing countries, RTD represent a challenge to public health because of their frequency, severity, projected trends, and economic impact. There have been persistently high rates of RTD, particularly of asthma and acute bronchitis, in pediatric hospitalizations, which were often unrecognized. 1,2In Tunisia, according to previous data, the prevalence of asthma was estimated to be around 4.3% in 2008 in children, in second place after the elderly. 3 Bronchiolitis hospitalizations have increased considerably since 1980, resulting in a problem for public health in Tunisia and the whole world. 4 This alarming situation prompted authorities and health-care managers to plan preventive actions as soon as possible. Climate factors and environmental change play a major role in the epidemiology of pulmonary infectious diseases, resulting in significant seasonal variations in terms of prevalence.5 Better knowledge of the new epidemiological profile will help decision makers to ...

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