Tracing of pulmonary tuberculosis cases among "goza" smokers using mycobacterial phage typing

The present study included 564 patients with chest symptoms belonging to 3 groups: 175 cigarette smokers, 160 "Goza" smokers [Hubble-bubble or water pipe] and 229 non-smokers. The objective was defining any relation between "Goza" smoking and pulmonary tuberculosis, with special utilization of the technique of Mycobaeteriophage typing in this respect. Results refer to a definite statistically significant increased incidence of pulmonary tuberculosis among "Goza" smokers [19.3%], versus cigarette smokers [5.7%] and non-smokers [4.8%]. There was also statistically significant difference in the clinical and radiological aspects between the 3 groups, namely: art increased incidence of haemoptysis [51.6%] and dyspnea [64.5%] in Goza smokers and more far-advanced extent of the disease among them [70.9%]. The resistance pattern of Mycobacteria isolated from tuberculosis "Goza smokers belonging to the same "Goza-smoking session', was the same, in each of 9 "sessions" from which the cases were collected. The same trend was obtained when the phage typing of the bacilli was correlated with the "Goza-smoking session'. The same phage type, was shown, among the patients collected from the particular session e.g. sessions I .2,3 and 4 showed only phage type A in all their tuberculous patients while session 6 showed phage type B. Phage type Ax was isolated only from session 7 and phage type C only from session 9 and phage type I from session 8. It can he concluded that the mass use of one 'Goza" in the concerned "Goza-smoking session', usually in an unwholesome atmosphere among consumers with low apprehension of symptom like cough and expectoration, is a definite risk factor for cross-infection with pulmonary tuberculosis discovered in an advanced stage. So, "Goza" smokers are a high vulnerable group, in this respect, that needs special epidemiological attention as a public health problem