Epidemiology of extra pulmonary tuberculosis in Eastern Sudan

Abstract

A B S T R A C TObjective: To investigate the epidemiological factors associated with extra pulmonary tuberculosis (EPTB) in Kassala, Eastern Sudan. Methods: Patients infected with TB (pulmonary and extra-pulmonary) documented at the hospital were interviewed with a structured questionnaire used to gather sociodemographic information. The diagnosis of EPTB cases was based on presence of tuberculous granulomas in the histological samples, positive PCR to DNA of mycobacterium tuberculosis, radiological findings and fluid analysis suggestive of EPTB and clinical diagnosis with adequate response to anti-tuberculous therapy. Results: A total of 985 patients with TB were enrolled in the study, including 761 (77.3%) with PTB and 224 (22.7%) with EPTB. The mean age (SD) of patients with PTB and EPTB was 33.2 (15.4) and 34.7 (14.6) years respectively. The prevalence of EPTB was at (22.7%), with TB lymphadenitis 79 (35.3%), marking the frequent form of EPTB followed by peritoneal TB 27 (12.05%). While residence and occupation were not associated with EPTB, those with lower level of education (OR = 0.3; confidence intervals (CI) = 0.2-0.5; P < 0.001), female (OR = 8.7, CI = 4.9-15.1, P < 0.001), non vaccination (OR = 70.3, CI = 34.2-144.3, P < 0.001), and non smoker (OR = 0.1; CI = 0.06-0.20; P < 0.001), were associated with high prevalence of EPTB. Conclusions: Around one quarter of patients with TB in this study were more likely to have EPTB. Therefore, effective strategic plans regarding diagnostic procedures and control measures are needed to reduce the burden of the disease in Sudan.

Assessment of Extrapulmonary Tuberculosis Using Gene Xpert MTB/RIF Assay and Fluorescent Microscopy and Its Risk Factors at Dessie Referral Hospital, Northeast Ethiopia

“…Our results also demonstrated that smoking was not associated with EPTB which is consistent with other studies [ 21 ] and smoking was reported as the risk factor for PTB compared with EPTB [ 32 ]. Similarly, in our study occupation and residence of participants were not associated with EPTB which is in agreement with study conducted in Sudan [ 21 ]. In the present study, only two samples demonstrated rifampicin resistant Mycobacterium tuberculosis complex making the prevalence of rifampicin resistant-TB 6.5% (2/31).…”

“…Similarly, studies conducted in other countries showed TB lymphadenitis as the common form of EPTB followed by pleural forms [ 18 – 20 ]. Recent reports from Sudan also indicated that TB lymphadenitis is the most frequent form of EPTB followed by peritoneal TB [ 21 ]. In contrast, other reports have shown pleural effusion as the most frequent form of EPTB, followed by lymphatic TB [ 22 , 23 ].…”

The effect of an educational intervention on awareness of various aspects of pulmonary tuberculosis in patients with the disease

“…The country accounts for 15% of the TB burden in the WHO Region for the Eastern Mediterranean (8). It was recently observed that 26.6% of patients with TB in the Region had extra-pulmonary TB (9,10).…”

A Patient Presented with High Fever and Bloody Pericardial Effusion (Hemorrhagic Pericarditis)

“…An extensive review on the causes of pericarditis conducted by Noubiap JJ, et al revealed that M. tuberculosisis a responsible agent in pericarditis, but not hemorrhagic pericarditis, and furthermore, no unique 2D-echocardiographic signs were detected [9]. A cross-sectional study from Sudan between January 2011 and June 2012 enrolled 985 patients, 22.7% (224) were extrapulmonary tuberculosis, only 1.9% [4] patients were pericardial, and none were hemorrhagic [10]. Our patient diagnosis was firmly based on bacterial culture (Figure 4), and on pericardial biopsywith the characteristic picture (Figure 2 A, B) and AFB on Ziehl-Neelsen stain of the pericardial biopsy (Figure 3).…”