Endometrial tuberculosis among patients undergoing endometrial biopsy at Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia

Sileshi Abdissa,Tamrat Abebe,Adane Mihret,Gobena Ameni,Yonas Bekuretsion,Sisay Teklu,Markos Abebe

doi:10.1186/s12879-018-3202-x

Sileshi Abdissa, Tamrat Abebe + Show 5 more

Open Access

https://doi.org/10.1186/s12879-018-3202-x

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Abstract

BackgroundFemale genital tuberculosis (FGTB) is known to cause severe tubal disease leading to infertility and its incidence closely parallels with the overall prevalence of tuberculosis (TB) in a community. Its magnitude is underreported because diagnosis is difficult and requires invasive techniques. In this study we determined the prevalence of endometrial tuberculosis and characterized isolates among women who underwent endometrial biopsy for evaluation of various conditions at a Tikur Anbessa Specialized Hospital (TAHS), Addis Ababa, Ethiopia.MethodsA cross sectional study was conducted on 152 consecutive gynecologic patients who underwent endometrial biopsy for different gynecologic diseases. Endometrial tissue taken for routine histopathology examination was shared after informed consent was obtained from the patient and subjected to polymerase chain reaction (PCR) and culture for Mycobacterium tuberculosis (Mtb).ResultsThe prevalence of endometrial TB in this study by IS1081PCR was 4.6% (7/152) while culture proven endometrial TB was 2.6% (4/152). However, histological examination identified only 2/152 (1.3%) endometrial tuberculosis. While all culture proven TB samples were also PCR positive for Mtb, only one histologic proven endometrial TB was culture and PCR positive. All of the four isolates by culture were M. tuberculosis.ConclusionThis study has shown that the magnitude of endometrial TB is fairly high in gynecologic patients visiting outpatient departments for various complaints and PCR detects more cases than culture or Histopathology.

Highlights

Female genital tuberculosis (FGTB) is known to cause severe tubal disease leading to infertility and its incidence closely parallels with the overall prevalence of tuberculosis (TB) in a community
The main purpose of this study was to determine the prevalence of endometrial tuberculosis and to characterize isolates among patients undergoing endometrial biopsy for histo-pathological examination, for gynecologic diseases, at Tikur Anbessa Specialized Hospital, using culture and polymerase chain reaction (PCR) techniques, and to compare the three methods
Prevalence of endometrial tuberculosis The prevalence of endometrial TB was determined by culture with species confirmed by Region of difference (RD) and IS1081-PCR for MTC

Summary

Introduction

Female genital tuberculosis (FGTB) is known to cause severe tubal disease leading to infertility and its incidence closely parallels with the overall prevalence of tuberculosis (TB) in a community. Its magnitude is underreported because diagnosis is difficult and requires invasive techniques. The prevalence of FGTB increases in countries with a high burden of high Pulmonary Tuberculosis (PTB). In addition to the subtle presentation of the disease, the low sensitivity and specificity of routine diagnostic methods and the paucity of the organism in clinical samples are the main factors for the lower detection of genital TB (GTB) [4]. Most cases of GTB are secondary to gastrointestinal TB spreading to the fallopian tubes causing TB salpingitis. The most frequent symptom of FGTB is infertility, as a result of irreversible damage to the fallopian tube [6].

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