Tract Tuberculosis Research Articles

Tuberculosis of Uterus: A Case Report

Female Genital Tract Tuberculosis is caused by Mycobacterium tuberculosis, being usually secondary to tuberculosis of the lungs. In Female Genital Tract Tuberculosis, fallopian tubes are affected in 90 percent woman, whereas uterine endometrium is affected in 70 percent and ovaries in about 20 percent. HIV induced immunosuppresion paves the way for several infections, tuberculosis being very common. This is a case of genital tuberculosis which was diagnosed after hysterectomy by histopathological examination in HIV patient. To describe an uncommon case of female genital tract tuberculosis diagnosed by histopathology. Total abdominal hysterectomy specimen was received. Brief clinical history was taken and clinical examination was done. Histopathological examination of hematoxylin & eosin stained sections was done. AFB staining was done to look for bacilli. Sections studied from endometrium and cervix revealed granulomas comprised of epithelioid cells, langhan’s type of giant cells. Testing for Tuberculosis & HIV should be undertaken because these are the infections which can affect any organ in the body. In patients with extra pulmonary tuberculosis, early institution of therapy & close clinical monitoring are keys to timely diagnosis and treatment of such co-infections. Keywords: Tuberculosis, HIV, Female genital tract

Hospital admissions of refugees, asylum seekers and undocumented migrants: Ten-year retrospective study

IntroductionThe worldwide population of forcibly displaced people has increased over the past decade, approaching 80 million and encompassing more than 30 million refugees and asylum seekers. Research into refugee and migrant health has remained scarce, however. MethodsTo investigate the reasons for hospital admissions of refugees, asylum seekers and undocumented migrants, we collected medical data from Helsinki University Hospital (HUH) records 2010–20. ResultsThe study population consisted of 647 patients originally from 54 different countries, mainly Iraq, Syria, and Afghanistan. Among adults, 40.9% of the admissions were related to pregnancy. For minors, the group comprising congenital malformations, deformations, and chromosomal abnormalities accounted for most hospitalizations, followed by diseases of the digestive or nervous system.Every fifth patient (19.3%) was admitted because of an infection: adults mostly for urinary tract infection (16.3%), pneumonia (14.1%), and tuberculosis (9.8%), and minors for acute gastroenteritis (15.2%). Infectious reason was more frequent within two months after immigration than later. ConclusionsOur data reveal a unique admission profile for forced migrants: in addition to infectious diseases, a particularly high rate of obstetric diagnoses was recorded, the two ranking as the most common reasons for hospitalization.

AN OBSERVATIONALANALYTICAL STUDY ON THE PREVALENCE OF FEMALE GENITAL TRACT TUBERCULOSIS AND ITS RELATION TO FEMALE INFERTILITY

INTRODUCTION:Tuberculosis is an infectious disease caused by Mycobacterium species, which are the acid fast bacillus. OBJECTIVES: The present study investigates the prevalence of genital tract tuberculosis among infertile women and its relation to infertility. MATERIALS AND METHOD: The present study is an hospital based analytical and observational study. Department of gynecology and obstetrics, IPGMER hospitals. March 2018 to august 2020. 100 female patients with infertility. CONCLUSION: In our study we reported 11 cases of female with genital tract tuberculosis, diagnosed during laparoscopy, conrmed by CBNAAT, conventional culture method and histopathological examination.

Хирургическое лечение обструкции верхних мочевых путей при туберкулезе мочевой системы

Introduction. Currently, the basis for effective treatment of urinary tuberculosis (UT) is a combination of specific chemotherapy with reasonable surgical intervention and strict follow-up of the patient. Materials and methods. This literature review presents the evolution of methods of surgical treatment of renal and upper urinary tract tuberculosis over of 127 sources found for the review, 63 were selected. Results. Since UT is a very slowly progressive disease with minimal and imperceptible symptoms, often leading to irreversible organ damage, up to 75% of patients with this pathology undergo surgery. As follows from the results of recent studies, the emphasis of surgical treatment is increasingly shifting from ablative and organ-carrying techniques to reconstructive operations. Surgery for upper urinary tract tuberculosis continues to develop, but its results in advanced cases of destruction of renal tissue often remain unsatisfactory. Conclusions. The search for new methods of reconstructive interventions, the purpose of which is to preserve functioning renal-ureteral units and improve the quality of life of patients, remains relevant.

P0128 - Relapses of urogenital tract tuberculosis

P0128 - Relapses of urogenital tract tuberculosis

Prevalence of the urinary tract tuberculosis in the structure of all forms and localizations of tuberculosis in children of preschool and primary school age

Introduction. Extrapulmonary tuberculosis is more difficult to diagnose than respiratory tuberculosis. However, late detection leads to disabling consequences. Children from 4 to 11 years old are at risk for tuberculosis due to increased communication skills. It seems relevant to isolate urinary tract tuberculosis (UTTB) in children of these age groups in the structure of all forms to improve its diagnosis.Purpose of the study. Isolation of urinary tract tuberculosis to determine the significance and improve the diagnosis of this localization of tuberculosis in the structure of all forms and localizations of tuberculosis in children of preschool and primary school age.Materials and methods. The cohort comparative study included 303 children aged 4 to 6 years and 306 children aged 7 to 11 years who had tuberculosis in the period from 2000 to 2018. The results were statistically processed using the Microsoft Office 2007 software package, Biostat 2009. Differences between the groups were determined using the Х2 test. The hypothesis of the absence of a statistically significant influence of the factor was rejected at p > 0.05.Results. Respiratory tuberculosis (RTB) was diagnosed in children of preschool and primary school age in most cases (94.7% and 89.9%; p < 0.05), bacteriological confirmation was found in 6.3% and 3.6% (p > 0.05) children in the compared age groups. Tuberculosis of the intrathoracic lymph nodes (TBILN) prevailed (85.7% and 75.3%; p < 0.05) in the structure of RTB. Primary tuberculosis complex (PTBC) was more often diagnosed in children of primary school age (23.3%) than in preschoolers (13.2%; p < 0.05). The registration frequency of isolated extrapulmonary forms of tuberculosis was 1.3% and 5.6% (p < 0.05), bacteriological confirmation of the diagnosis was 25,0% and 35.3% (p > 0.05). Most of the detected cases of isolated extrapulmonary tuberculosis accounted for UTTB - 50,0% and 64.7% (p > 0.05), all cases were confirmed bacteriologically. Generalization of the tuberculous process was noted in 4.0% and 4.6% of cases (p > 0.05). Most cases of generalized tuberculosis in children from 4 to 11 years old were associated with a combination of tuberculosis primary forms, mainly (TBILN) and in one case of PTBC, with UTTB (83.3% and 85.7%; p > 0.05). These cases of combinations were confirmed bacteriologically.Conclusion. Children of preschool and primary school age were diagnosed most often with TBILN. Isolated extrapulmonary tuberculosis was rare; UTTB predominated with frequent bacteriological confirmation. Isolated extrapulmonary tuberculosis was rare, UTTB of the predominated with frequent bacteriological confirmation. Generalization of tuberculosis in children 4-11 years old was rare; isolated forms of extrapulmonary tuberculosis were more often diagnosed. Most of the cases of combined localizations were due to a combination of TBILN and UTTB. UTTB was confirmed by the detection of M. tuberculosis in urine cultures. Physicians of primary health care and specialized services should be aware of the possibility of developing UTTB in children from 4 to 11 years old and search for the pathogen in patients with chronic UTIs and infected with M. tuberculosis.

Male genital tract tuberculosis: Acomprehensive review of imaging findings and differential diagnosis.

Urogenital tuberculosis is the most common form of extrapulmonary tuberculosis. Genital organ involvement occurs as a continuum of urinary tract tuberculosis and often presents a diagnostic challenge due to the non-specific nature of the symptoms. Delay in diagnosis may lead to complications such as infertility and perineoscrotal sinuses. Imaging plays an important role in raising timely suspicion of tuberculosis. In this article, we describe the imaging findings of male genital tuberculosis and the differential diagnosis. High-resolution ultrasonography (HRUS) is the best modality for assessing the epididymis, testis, scrotum and vas deferens, whereas MRI is optimal for evaluating the prostate, seminal vesicles and ejaculatory ducts. Epididymis is the most common site of genital tuberculosis, and presents as a nodular lesion limited to the tail or as diffuse enlargement. The proximal vas deferens is also frequently involved due to anatomical contiguity and shows diffuse or nodular thickening. Advanced cases may show pyocele formation and scrotal wall sinuses. Testicular involvement is almost always secondary to epididymal tuberculosis and presents as single or multiple nodules, diffuse enlargement, or the 'miliary' pattern. Isolated testicular involvement should raise suspicion of malignancy. Tuberculosis of the prostate is often asymptomatic. The most common imaging manifestations are nodules and the diffuse forms, which may later evolve into abscesses. Fibrosis and calcification occur with healing. Seminal vesicle and ejaculatory duct involvement with fibrosis may cause infertility. Awareness of the imaging findings would enable the radiologist to raise timely suspicion, so that prompt treatment is initiated and complications are prevented.

DANGER TO PUBLIC HEALTH PROGRAMS IN THE WAKE OF COVID-19

The time when the world is dealing with corona disaster, there is this fear that we might not forget about other communicable diseases. There are multiple international and national programs in place to prevent these communicable diseases. The fear is these programs might not get the attention it deserves at the time when all the attention is toward Covid-19. Currently more than 180 countries/regions have reported Covid-19 cases.1 The highly contagious measles cases have continued to increase. World Health Organization (WHO) data shows that globally measles cases rose by 300 percent in the first three months of 2019, compared to the same time period of 2018. The WHO African region has recorded a 700% increase, the Region of the Americas 60%, the European region 300%, the Eastern Mediterranean 100%, with 40% increases in Southeast Asia and the Western Pacific. According to statistics, it caused approximately 110,000 deaths worldwide in 2017.1,2 The point of concern is that even countries with high overall vaccination coverage like USA and Israel noted spikes in cases. United States recorded 1,282 individual cases of measles, greatest number since 1992.3 Speaking about polio, countries are still struggling with its eradication. Afghanistan, Nigeria and Pakistan are still endemic recording total of 29, 18 and 146 cases respectively in 2019.4 These are the countries currently dealing with the COVD-19 pandemic too. As of March 15, 2020, the Khyber Pakhtunkhwa Province of Pakistan reported 13 new circulating vaccine derived poliovirus (cVDP2) cases, the largest number of cases the province has ever seen in a day.5 According to WHO, Lower respiratory tract infections remained the deadliest communicable disease, causing 3.0 million deaths globally in 2016. Diarrheal diseases caused 1.4 million deaths in 2016. Similarly, Tuberculosis (TB) was responsible for 1.3 million deaths globally. Lower respiratory tract infections, Diarrhea diseases and Tuberculosis are among the top ten global causes of deaths. The situation at hand demands extra measures on the part of authorities and public health experts. With the Covid-19 pandemic, trend has been observed where there is diversion of all human and budgetary resources toward Covid -19 pandemic. This pandemic and helplessness of many nations to deal with it alarms us that we are not capable of dealing with another pandemic at this time. Therefore, it is important that all those programs i.e. Immunization programs, TB, HIV, Hepatitis control programs etc. must continue at the same time. Otherwise, more deaths might result associated with these communicable diseases than the overall endeavor would save from Covid -19.

Update on urogenital tuberculosis in Southern Tunisia: a review of a 26-year period.

Tuberculosis affects commonly the lungs, but any other organs can be affected as well. Urogenital tuberculosis is usually misdiagnosed. In this perspective, we aimed to give an update on the epidemiological, clinical and evolutionary features of urogenital tuberculosis in Southern Tunisia. We conducted a retrospective study including all patients with extrapulmonary tuberculosis notified during the period from 1992 to 2017 in Southern Tunisia. We specified the particularities of urogenital tuberculosis cases, and we compared them with other extrapulmonary tuberculosis cases. Overall, we analyzed 240 cases with urogenital tuberculosis, among 1702 patients with extrapulmonary tuberculosis (14.1%). There were 121 women (50.4%). The mean age was 49±17 years. Multifocal tuberculosis was noted in 29 cases (12.1%). There were 169 cases with urinary tract tuberculosis (70.4%). Chronological trends analysis showed that the median age at diagnosis increased significantly (Rho=0.41; p=0.039) and the number of urogenital tuberculosis declined during the study period, without a statistical significance (Rho = -0.07; p=0.721). Compared to other extrapulmonary tuberculosis sites, patients aged 60 years and above (OR=2.7; p<0.001) and coming from rural areas (OR=1.4; p=0.021) were more frequently diagnosed with urogenital tuberculosis. Treatment duration was significantly longer in patients with urogenital tuberculosis (10.13±3.79 vs 9.20±3.77 months; p<0.001). As for the disease evolution, relapse was significantly more frequent in patients with urogenital tuberculosis (OR=4.1; p=0.045). Although decreasing trends over time were noted, the prognosis of urogenital tuberculosis was more severe compared to other extrapulmonary tuberculosis sites.

Differential diagnosis of urinary syndrome

The article presents the clinician's view on general diagnostic and differential diagnostic approaches when analyzing data of the urine test in patients with nephrological, therapeutic and urological pathology. Features of the urinary syndrome are examined in detail depending on the presence, degree and severity of haematuria, leukocyturia, proteinuria, cylindruria in various diseases. Moments of diagnosis and clinical examination of patients with urolithiasis, kidney and urinary tract tumors, urinary tract tuberculosis, renal vascular anomalies, cystic dysplasia, and nephroptosis are described in detail in addition to traditional chronic kidney diseases (glomerulonephritis, pyelonephritis, interstitial nephritis).

A Female Patient With Clinical Symptoms as Recurrent Urinary Tract Infection Caused By Urinary Tract Tuberculosis

Background : Urinary tract tuberculosis (TB) is one type of extrapulmonary TB. The prevalence in developed countries is around 15-20% of all cases of extrapulmonary TB.1 The insidious onset and non-specific constitutional symptoms of urinary tuberculosis often lead to delayed diagnosis and rapid progression to a non-functioning kidney.2-3 The only way to limit renal function loss and destruction is by early diagnosis and therapy.4Case: 34-year-old woman, came with complaints of urinary pain accompanied by right flank pain 10 months prior. Patient also had complaint of weight loss but ignoring complaints of night sweats. Patient repeatedly diagnosed as a urinary tract infection and received many kinds of antibiotic therapy but her complaints were not getting better. Urine production was about 1700 cc/24 hours. From general physical examination, there was a lack of nutritional status with BMI 17.1 kg/m2. Vesicular lung sound without rhonchi heard in both lung fields. From the urinalysis examination there were pyuria and haematuria without bacteriuri. Laboratory examination showed value of BUN was 17 mg/dl and creatinine 0.9 mg/dl. From aerob urine culture we found sterile urine. But we found positive result of Mycobacterium tuberculosis (MTB) urine cultures which was sensitive to isoniazid, rifampicin, pyrazinamide, and ethambutol. Abdominal ultrasound showed severe ecstasis of right pelviocalyceal system without stones,mass, nor cyst. We had additional data from intravenous pyelogram (IVP) which showed a non-visualized dextra pelviocalyceal system and delayed bladder emptying function at 120th minutes. From computed tomography stonographic, we found severe right hydronephrosis, proximal to distal right hydroureter, and thickening of bladder wall (± 1.61 cm) on the right antero-lateral side. To find out the cause of thickening of bladder wall, we did bladder biopsy which showed the mononuclear inflammatory cell stroma. Patients were diagnosed with urinary tract TB and received category 1 of oral anti tuberculosis therapy (Rifampicin, Isoniazid, Pyrazinamid, and Ethambutol) for 12 months and underwent right DJ stent implantation to manage the ectasys.Conclusion : Urinary tract TB often showed unspecified complaints and can be suggested as recurrent urinary tract infections. Early diagnosis and optimal management were needed to prevent anatomical and functional complications.

The association between vitamin D status and infectious diseases of the respiratory system in infancy and childhood.

PurposeRespiratory tract infections (RTIs) are a major cause of illness worldwide and the most common cause of hospitalization for pneumonia and bronchiolitis. These two diseases are the leading causes of morbidity and mortality among children under 5 years of age. Vitamin D is believed to have immunomodulatory effects on the innate and adaptive immune systems by modulating the expression of antimicrobial peptides, like cathelicidin, in response to both viral and bacterial stimuli. The aim of this review is to summarize the more recently published data with regard to potential associations of 25-hydroxyvitamin D [25(OH)D] with infectious respiratory tract diseases of childhood and the possible health benefits from vitamin D supplementation.MethodsThe literature search was conducted by using the PubMed, Scopus, and Google Scholar databases, with the following keywords: vitamin D, respiratory tract infection, tuberculosis, influenza, infancy, and childhood.ResultsSeveral studies have identified links between inadequate 25(OH)D concentrations and the development of upper or lower respiratory tract infections in infants and young children. Some of them also suggest that intervention with vitamin D supplements could decrease both child morbidity and mortality from such causes.ConclusionsMost studies agree in that decreased vitamin D concentrations are prevalent among most infants and children with RTIs. Also, normal to high-serum 25(OH)D appears to have some beneficial influence on the incidence and severity of some, but not all, types of these infections. However, studies with vitamin D supplementation revealed conflicting results as to whether supplementation may be of benefit, and at what doses.

Genital Tract Tuberculosis in a 42-year Female Masquerading as Ovarian Malignancy

Female genital tuberculosis is one the known causes of infertility in the tropics. The symptom complex are diverse and it is one of the known causes of pyrexia of unknown origin. Instances of mimicry of ovarian cancer with raised CA125, have been reported. We present a case report in a 42-year-old woman with abdominal pain and progressive abdominal pain of 3 weeks durations, who had confounding symptom of raised CA125, forcing a presumptive diagnosis of ovarian cancer. She had exploratory total abdominal hysterectomy (TAH). The surgical findings and histopathological diagnosis were suggestive of tuberculosis, for which she is undergoing treatment and showing remarkable improvement.

Is sterile pyuria another minor diagnostic criterion in urinary tuberculosis?

IntroductionComposite reference standard (CRS) is used for diagnosis of urinary tract tuberculosis (UTB). We examined if addition of a new ‘component test’ as minor criterion in the form of SP could improve the yield. MethodsWe identified patients admitted with a diagnosis of UTB from January 2009 to February 2016 from our patient database. We performed the validation of addition of a new ‘component’ “sterile pyuria” to the existing basic CRS. ResultsSP was seen in 50 patients (65.7%). Forty (52.6%) of these patients had one major criterion positive and 10 (13.1%) were diagnosed based on minor criteria. If SP was added as a minor criterion, an additional 8 (9.2%) patients would have been diagnosed based on minor criteria alone without the need for a histopathology. ConclusionsSP could improve the diagnostic yield of existing CRS by 8% with a 70% decrease in reliance on histopathology for diagnosis.

Multicentre evaluation of Xpert MTB/RIF assay in detecting urinary tract tuberculosis with urine samples

Genitourinary tuberculosis (GUTB) accounts for up to 40% of extrapulmonary tuberculosis cases. Rapid tests for GUTB are urgently needed because it is often associated with delayed health-care seeking, leading to serious consequences. This study evaluated the performance of the Xpert MTB/RIF assay in the rapid diagnosis of urinary tract tuberculosis (UTB) and rifampicin-resistant tuberculosis with urine specimens. In all, 302 patients were included from four hospitals in China. Suspected UTB patients were tested with Xpert, smear, and MGIT 960 culture. Drug susceptibility testing (DST) was conducted for culture-positive cases. The performance of the assays was evaluated against MGIT 960 culture and a composite reference standard (CRS). Among all participants, 150 (49.7%) had CRS-positive UTB, of whom 36 (24.0%) were culture-confirmed. Against culture, Xpert and smear achieved a sensitivity of 94.4% (95% CI: 81.3–99.3%) and 22.2% (95% CI: 10.1–39.2%), respectively. Against CRS, the sensitivity of Xpert, smear and culture was 41.3% (95% CI: 33.4–49.7%), 7.3% (95% CI: 3.7–12.7%), and 24.0% (95% CI: 17.4–31.6%). Xpert had better performance than smear and culture in detecting UTB from urine samples and could be considered for the diagnosis of UTB. Moreover, Xpert showed better performance than MGIT 960-based DST using urine culture.

Phage Lysins for Fighting Bacterial Respiratory Infections: A New Generation of Antimicrobials.

Lower respiratory tract infections and tuberculosis are responsible for the death of about 4.5 million people each year and are the main causes of mortality in children under 5 years of age. Streptococcus pneumoniae is the most common bacterial pathogen associated with severe pneumonia, although other Gram-positive and Gram-negative bacteria are involved in respiratory infections as well. The ability of these pathogens to persist and produce infection under the appropriate conditions is also associated with their capacity to form biofilms in the respiratory mucous membranes. Adding to the difficulty of treating biofilm-forming bacteria with antibiotics, many of these strains are becoming multidrug resistant, and thus the alternative therapeutics available for combating this kind of infections are rapidly depleting. Given these concerns, it is urgent to consider other unconventional strategies and, in this regard, phage lysins represent an attractive resource to circumvent some of the current issues in infection treatment. When added exogenously, lysins break specific bonds of the peptidoglycan and have potent bactericidal effects against susceptible bacteria. These enzymes possess interesting features, including that they do not trigger an adverse immune response and raise of resistance is very unlikely. Although Gram-negative bacteria had been considered refractory to these compounds, strategies to overcome this drawback have been developed recently. In this review we describe the most relevant in vitro and in vivo results obtained to date with lysins against bacterial respiratory pathogens.

Magnitude of opportunistic diseases and their predictors among adult people living with HIV enrolled in care: national level cross sectional study, Ethiopia

BackgroundOpportunistic diseases cause morbidity and mortality among human immunodeficiency virus (HIV) infected persons. There is dearth of evidence on the magnitude and predictors of opportunistic diseases among PLHIV in Ethiopia. This study was conducted to determine the magnitude and predictors of opportunistic diseases among adults enrolled in the national HIV/AIDS care and treatment services and generate information for program planning and medicine quantification in the country.MethodsA health facility-based cross-sectional study was conducted. Probability proportional to size and random sampling methods were employed to select health facilities and medical records of adult HIV-infected patients respectively. A total of 7826 medical records were reviewed from 60 health facilities nationwide. Socio-demographic and clinical data including diagnosis of opportunistic diseases were collected from the medical records. Period prevalence of opportunistic diseases over one year period was determined. Bivariate and multivariate logistic regression was used to measure associations between independent variables and the dependent variable, occurrence of opportunistic diseases.ResultsOf the total of 7826 study participants, 3748 (47.9%) were from hospitals and 4078 were from health centers. The majority (61.8%) were female. The median age was 32 years with interquartile range (IQR) of 27–40. The median duration of stay in HIV care was 56 (IQR = 28–80) months; 7429 (94.9%) were on antiretroviral treatment. A total of 1665 cases of opportunistic diseases were recorded with an overall prevalence estimated at 21.3% (95% confidence interval (CI): 20.36, 22.18%). Skin diseases (4.1%), diarrhea (4.1%), bacterial pneumonia (3.6%), recurrent upper respiratory tract infections (3.1%) and tuberculosis (2.7%) were the leading opportunistic diseases. Isoniazid preventive therapy coverage among eligible patients was 24.8%. Persons with a CD4 count < 200 cells/mm3 [adjusted odds ratio (AOR) 1.80, 95% CI: 1.45, 2.23]; and who were bed ridden or ambulatory functional status [AOR (95% CI) = 3.19 (2.32, 4.39)] were independent predictors of diagnosis of opportunistic diseases.ConclusionOpportunistic diseases were found to be pervasive among HIV infected adults in Ethiopia. Proactive identification and management, and prevention of opportunistic diseases should be strengthened especially among females, ambulatory or bed-ridden, and patients with low CD4 cell count.

Prevalence of extra pulmonary tuberculosis among medical workers

The authors analysed data of epidemiologic situation concerning prevalence of extrapulmonary tuberculosis in Russian Federation. Risk of the infection is maximal in laboratory workers. The article covers data of comparative analysis of epidemiologic well-being with diagnosed cases of occupational tuberculosis. Conclusions are better epidemiologic situation due to interactions with epidemiologic and sanitary services. Over the studied period, bone and joints tuberculosis and urinary tract tuberculosis appeared to be more epidemiologically important. Dynamics of occupational extrapulmonary tuberculosis cases are presented. Among all types of occupational extrapulmonary tuberculosis, bone and joints tuberculosis and lymphatic node tuberculosis were prevailing.

Endoscopic Findings of Female Genital Tract Tuberculosis: A 3-year Analysis at a Referral Center

Endoscopic Findings of Female Genital Tract Tuberculosis: A 3-year Analysis at a Referral Center

Trends in Infectious Disease Mortality, South Korea, 1983-2015.

We used national statistics from 1983–2015 to evaluate trends in mortality caused by infectious diseases in South Korea. Age-standardized mortality from infectious disease decreased from 43.5/100,000 population in 1983 to 16.5/100,000 in 1996, and then increased to 44.6/100,000 in 2015. Tuberculosis was the most common cause of death in 1983 and respiratory tract infections in 2015. We observed a significant decline in infant deaths caused by infectious diseases, but mortality in persons age >65 years increased from 135 deaths/100,000 population in 1996 to 307/100,000 in 2015. The relative inequality indices for respiratory tract infections, sepsis, and tuberculosis tended to increase over time. Although substantial progress has been achieved in terms of infant mortality, death rates from infectious disease has not decreased overall. Elderly populations with lower education levels and subgroups susceptible to respiratory infections and sepsis should be the focus of preventive policies.