Tuberculosis Trends in the Kingdom of Saudi Arabia, 2005 to 2009

Abstract

Policymakers should know the distribution and determinants of tuberculosis (TB) over time. This is especially true for the Kingdom of Saudi Arabia (KSA), a country at increased risk for TB transmission because of mass gatherings (e.g., Hajj) and a large number of immigrant workers. Using national TB notification data reported from 13 provinces from 2005 through 2009, trends in annual TB incidence were calculated by nationality, age, and gender. Compared with Saudis, non-Saudis had a 2-fold greater TB incidence rate each year. In 2009 among all KSA provinces, Makkah had the greatest proportion of non-Saudis (38%), the greatest number of TB cases (1648), and the highest TB incidence rate (26 per 100,000). We observed significantly increasing yearly trends of TB incidence among Saudis in the Najran province (21.3%) and in Riyadh (8.5%). Conversely, we observed a significantly decreasing yearly trend among non-Saudis in Baha (23.1%), Hail (17.4%), and the Eastern region (22.6%). Disparate KSA regional and longitudinal TB trends existed from 2005 through 2009, by nationality. We recommend a review of all TB policies in KSA that addresses screening for latent TB infection and drug resistance. Additionally, we recommend a new TB public health education program.