Abstract
IntroductionIn contrast to most tuberculosis (TB) high burden countries, Ethiopia has for a long time reported a very high percentage of extra pulmonary TB (EPTB), which is also reflected in population based estimations reported by the World Health Organization (WHO). Particularly a steadily higher proportion of cervical tuberculous lymphadenitis (TBLN) has been described. Here we identify clinical and demographic factors associated with anatomic site of the TB disease. MethodA health facility based comparative study was conducted among TBLN and PTB patients who visited selected health facilities in Ethiopia during 2016 and 2017. Associated risk factors were identified through a multivariate logistic regression model using R-studio. ResultA total of 1,890 study participants, 427 TBLN and 1,463 PTB patients, were included. The mean age of TBLN patients (29 years ± 14.4 SD) was lower than that of PTB cases (36 years ± 15.0 SD). There were slightly more women diagnosed with TBLN (51.1%) while nearly 6 out of 10 male patients were diagnosed with PTB (58.9%). Most significantly, younger age groups (<15 Years) were more likely to develop cervical TBLN than older people (>56 years), with an AOR of 9.76 (95% CI: 4.87, 19.56). The odds of cervical TBLN among women [1.69 (1.30, 2.20)] was higher than that for men. In addition, adjusted estimates suggested that, compared with PTB, renal diseases [3.41 (1.29, 9.02)] and the presence of other concomitant chronic illness [1.61 (1.23, 2.09)] had a significant association with TBLN. ConclusionGenerally, the risk of developing a particular form of TB disease is usually associated with demographic and medical history of an infected individual. Hence, the current symptom based screening, which primarily rely on chronic cough in many countries, may lead to missing significant portions of TBLN cases.
Highlights
In contrast to most tuberculosis (TB) high burden countries, Ethiopia has for a long time reported a very high percentage of extra pulmonary TB (EPTB), which is reflected in population based estimations reported by the World Health Organization (WHO)
This study aimed to identify demographic and clinical factors that could be associated with an increased prevalence of tuber culous lymphadenitis (TBLN) diseases in Ethiopia as compared to PTB
There were slightly more women diagnosed with TBLN (51.1%), while nearly 6 out of 10 patients diagnosed with PTB (58.9%) were male (Table 1)
Summary
In contrast to most tuberculosis (TB) high burden countries, Ethiopia has for a long time reported a very high percentage of extra pulmonary TB (EPTB), which is reflected in population based estimations reported by the World Health Organization (WHO). Adjusted estimates suggested that, compared with PTB, renal diseases [3.41 (1.29, 9.02)] and the presence of other concomitant chronic illness [1.61 (1.23, 2.09)] had a significant association with TBLN. In reverse relationship with the crude prevalence, relatively higher percentage of EPTB cases were estimated from many low burden settings [3,4,5], suggesting that, in countries with successful TB control programs, the incidence of PTB but not EPTB cases have significantly decreased during such programs [3,6].
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More From: Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
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