Prevalence of Tuberculosis Among High Altitude Residents of Nepal

Abstract

Introduction: Tuberculosis is a global health concern, and its prevalence can vary widely from one region to another. Factors such as altitude, climate, population density, and healthcare infrastructure can all influence the dynamics of Tuberculosis in a particular area. This study aimed to provide insights into whether altitude played a role in the occurrence of tuberculosis and its different forms in the specific region of Jumla the western rural district of Nepal. 
 Methods: Jumla is a high-altitude mountainous region ranging from 915m- 4679 m with a population of 119,337 (2021) having 8 municipalities. Data were collected from all the municipalities over a period starting from July 15th2021-July 14th2022 and were compared with prior years in number and diagnosis with national data of Nepal. 
 Results: A total of 84 cases were recorded of which 52.4% (n=44) were females. The group affected most was between the ages 16-30 years (34.5%) and 61-75yr (22.6%). The cases detected by the sputum Xpert MTB/RIF testing were 54.7%, with positive sputum Acid-fast bacilli being 27.4%. Most of the patients were diagnosed to have pulmonary bacteriologically confirmed (PBC) tuberculosis 52.4%, PCD (Pulmonary clinically diagnosed) 16.7%, Extra-pulmonary 28.6% with one case of each multi-drug resistant tuberculosis (MDR-TB), and Pre-XDR (Extensive drug resistant) TB. Among them, 12% of people had a history of TB undergone ATT (anti-tuberculosis drugs) in the past with 6% having a close contact history. 
 Conclusions: Tuberculosis infection, disease, and mortality seem to be less common at high than low altitudes. As in Karnali Province, Humla with the second being Jumla has the lowest number of TB patients than other parts of Nepal, affecting younger people.