Original Research Article
Year: 2020 | Month: October | Volume: 10 | Issue: 10 | Pages: 227-235
Independent Determinants of Predominant Emphysematics-Phenotyping in the Chest Scanner in Three Medical Training of Kinshasa: Cross Sectional Study
Fiston Dikamba Fiondo1, Benjamin Longo Mbenza2,3, Hervé Alex Tukadila3, Aliocha Nkodila Natuhoyila3, Michel Lelo Tshikwela1, Jean Mukaya Tshibola1
1Department of Radiology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
2Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
3Department of Public Health, Lomo University Research, Kinshasa, Democratic Republic of Congo
Corresponding Author: Nkodila Natuhoyila Aliocha
ABSTRACT
Background and Objective: Chronic obstructive pulmonary disease (COPD) is predicted to be the third leading cause of death worldwide by 2020. Its diagnosis remains a challenge in developing countries such as DRC, with the use of Gold standard, spirometry, limited. Chest imaging plays an important role in orientation. The absence of local radiological data from COPD had therefore motivated this study.
The objective of this study was to define the radio-CT metric aspects of COPD in our environment and determine their association with the clinical phenotype.
Materials and Methods: Retrospective and analytical study of clinical and thoracic imaging data (radiography and CT scan), collected from the records of 120 COPD subjects followed in three Kinshasa medical trainings between January 2014 and June 2017.Fisher's test compared the results obtained. The combination of imaging data and clinical phenotype through Pearson chi-square testing, logistic regression and odds-ratio (OR). The service threshold was set at 0.05.
Results: the study population (average age of 64.52±6.82 years) was predominantly male (78.3% n=94). The main risk factors were tobacco (32.5% n=39) and domestic pollution (30.8% n=37). The consultation took place at Stage II (42.5% n=51) and Stage III of GOLD (36.7% n=44). The TDM phenotype reached mixed was (50% n=4) at stage III and (83.3% n=10) at stage IV with a 0.001. The dominant emphysematic TDM phenotype was (25% n=2) at stage III and (66.7% n=8) at stage IV with a p= 0.029.
Conclusion: This study showed that diagnosis was often delayed. Stage III and IV of COPD were associated with the predominant emphysematic and mixed-achieving TDM phenotype, while stage I and II were associated with the predominant TDM type phenotype with airway.
Key words: COPD, Clinical and Radiological Profile, Kinshasa.