Tuberculosis Trends in Saudis and Non-Saudis in the Kingdom of Saudi Arabia – A 10 Year Retrospective Study (2000–2009)

Abstract

Background Tuberculosis (TB) remains a public health problem in the Kingdom of Saudi Arabia (KSA), which has a very large labour force from high TB endemic countries. Understanding the epidemiological and clinical features of the TB problem, and the TB burden in the immigrant workforce, is necessary for improved planning and implementation of TB services and prevention measures. Methods A 10 year retrospective study of all TB cases reported in KSA covering the period 1st January 2000 to 31st December 2009. Data was obtained from TB reporting forms returned to the Ministry of Health. Data were then organised, tabulated and analysed for annual incidence rates by province, nationality, country of origin and gender. Results There was an annual increase in the number of TB cases registered from 3,284 in 2000 to 3,964 in 2009. Non-Saudis had nearly twice the TB incidence rate compared to Saudis (P = <0.05). All but four provinces (Najran, Riyadh, Makkah, Tabuk) showed decreasing TB incidence rates. The highest rates were seen in the 65+ age group. In the 15–24 year age group the incidence rate increased from 15.7/100,000 in 2000 to 20.9/100,00 in 2009 (P = <0.05). The incidence of TB in Saudi males was higher than Saudi females. Conversely, for non-Saudis the TB incidence rates were significantly higher in females compared to males. Conclusions Despite significant investments in TB control over 15 years, TB remains an important public health problem in the KSA affecting all age groups, and Saudis and non-Saudis alike. Identification of the major risk factors associated with the persistently high TB rates in workers migrating to KSA is required. Further studies are warranted to delineate whether such patients re-activate latent Mycobacterium tuberculosis (M.tb) infection or acquire new M.tb infection after arrival in KSA. Appropriate interventions are required to reduce TB incidence rates as have been implemented by other countries.

Mycobacterium tuberculosis complex: Detection and patterns of resistance to the first line anti-TB drugs at the King Abdulaziz University Hospital, Saudi Arabia

“…This observation was not compatible with results obtained by Abouzeid et al [11] in their 10-year retrospective study, where non-Saudis had nearly twice the TB incidence rate compared to Saudis. Our result may be explained by the size of our patients , sample which was small to reveal a statistically significant data.…”

Mycobacterium Tuberculosis in Solid Organ Transplantation: Incidence before and after Expanded Isoniazid Prophylaxis

“…There are no new general population data on LTBI prevalence, but the incidence rate has decreased over the last ten years. 24 Nevertheless, the reduction in the incidence of tuberculosis in kidney recipients cannot be attributed to the incidence reduction in the general population alone. Compared to general population incidence rates of 2013, the incidence of tuberculosis in recipients of kidneys from a living-related donors is 8 times higher, in recipients of kidneys from deceased donors it is 14 times higher, in recipients of livers it is 42 times higher, in recipients of hearts it is 40 times higher, and in recipients of lungs it is 339 times higher.…”

Tuberculosis in Saudi Arabia: the journey across time

“…In addition, HIV seropositivity, smear positivity, and previous history of TB treatment were also predisposing factors behind elevated mortality [4]. The incidence rate of TB is two or three times higher in the immigrant population compared with the local population [5]. Furthermore, annual statistical data from the Ministry of Health showed a declining trend of incidence among non-Saudis and a stable trend among Saudi nationals ( Figure 2).…”

“…Regional differences in the incidence rate of TB in the country have been clearly demonstrated in several studies [5][6][7][8]. Some regions showed a decrease in TB prevalence, whereas other regions with a high number of immigrants showed an increase in TB incidence [9].…”