Tuberculous and non‐tuberculous cervical lymphadenopathy incidence and distribution in Somalia from 2016 to 2020: A review of 241 cases

Abstract

Objective To determine the incidence of tuberculous lymphadenitis (TBL) and other pathologies in cervical lymphadenopathies in Somalia and accompanying radiological findings. Methods In this hospital‐based retrospective study, the demographic characteristics, pathology results and radiological findings of 263 patients who underwent ultrasound (US)‐guided cervical lymph node biopsy between January 2016 and February 2020 were analyzed. Results Of 241 patients 118 men and 123 women (mean age 27.9 ± 18.1 years) included in the study, 46.1% (n = 111) were diagnosed as necrotizing granulomatous lymphadenitis (caseified, consistent with TBL) and 21.6% (n = 12, atypical lymphoid cells and n = 40, metastases) as malignancy. The most common type of metastasis was squamous cell cancer (n = 31), and the primary source of most of them was esophageal cancer (16/31, 51.6%). The age of patients with TBL was significantly lower than that of non‐TBL (21.9 ± 14.6 vs. 41.9 ± 24.6, P = 0.003) and the incidence of TBL in pediatric patients was statistically higher (58.0% vs. 21.5%, P = 0.019). The rate of patients with TBL being localized at level 4 and level 5 was significantly more than non‐TBL patients (18.0% vs. 10.0% and 23.4% vs. 10.8%, respectively, P = 0.01). Half of patients with TBL who have chest radiography had pathological findings; consolidation and bronchopneumonia were present in 52.6% of them. There were 2 patients with paravertebral abscess and one patient with gastrointestinal tuberculosis. Conclusion In Somalia, in the presence of cervical lymphadenopathy, after diagnosis by using US‐guided biopsy; primarily considering of TBL and malignancy, thoracic involvement should be investigated, and esophageal carcinoma must be excluded in terms of metastatic lymph node.

An Example of the Importance of Electronic Health Records from Mogadishu, Somalia: Hepatitis B Prevalence and Co-infections with Hepatitis C

“…change in the frequency of malaria over the years [12], tuberculosis prevalence and complications [13][14][15], incidence and distribution of cancer cases [16], antibiotic resistance rates [17,18], frequency of thyroid diseases [19], causes of blindness [20], and prevalence of various other organ-specific diseases and infections [21][22][23].…”

Tuberculosis in a weak health system, conflict and fragile zone: The monetary value of human lives lost associated with deaths of persons older than 14 years in Somalia

“…Evidence suggests that undetected TB cases are common, especially for high‐risk groups in high‐burden countries 54–57 and lack of resources limit strategies to control TB 58–60 . For the case of Somalia where TB is a serious public health problem, fewer than half of the estimated cases are detected 61 …”

“…[58][59][60] For the case of Somalia where TB is a serious public health problem, fewer than half of the estimated cases are detected. 61 That said, it should be noted that there is also the possibility that fragility conditions directedly kill people via armed conflicts before they can die of TB. Relative to deaths related to armed conflicts and other causes, TB is a slower killer.…”

Radiologically Advanced Pulmonary Tuberculosis in Mogadishu, Somalia: A Review of 206 Cases with Acid Fast Bacilli Smear-Positive Sputum

“…TB is an important public health problem in Somalia and is an important cause of death and disease burden [6][7][8]. Despite the prevalence of TB in the country, deficiencies in diagnosis and treatment still remain [9].…”