Urogenital Tuberculosis in the Niger Delta region of southern Nigeria: Our experiences, challenges, features and outcome

Abstract

Introduction: Tuberculosis (TB) has high morbidity and mortality. It’s prevalent in Niger Delta Region of Nigeria but urogenital TB (UGTB) appears neglected in the region. We present our 17-year experiences, challenges in diagnosis and treatment of UGTB in Port Harcourt, a centre for TB treatment in the region. Materials Methods: Consecutive urology patients managed at University of Port Harcourt Teaching Hospital (UPTH), Nigeria (1/1/2005-31/8/2022) were evaluated. Those with provisional diagnosis of UGTB were further investigated with confirmatory and staging tests for TB, including Gene Expert Ultra studies and histopathology. Patients with diagnosis of UGTB were given anti-tuberculous chemotherapy, operated surgically as indicated, and had active surveillance. Data were collected contemporaneously with management of patients and collated with simple statistics. Results: Total of 36,176 were evaluated. Nine (9) had diagnosis of UGTB and here reported. Hospital incidence of UGTB was 25 /100000 patients’ population. Four (4) patients were male and 5 female. Mean age at presentation (years) was 46.5 ±.9.7, and age range 23-79. Five female and 1 male patients had kidney TB (KTB); and 1 pulmonary TB with TB cysto-prostatitis. Four patients presented with grades 3 and 4 KTB, nephrolithiasis and multiple pus-laden renal cysts. Conclusion: UGTB is common in the region but confirmatory diagnostic tests lack good sensitivity. Patients presented late with high disease burden and often required surgical intervention. Combinations of high index of suspicion, clinical assessment with non-confirmatory/confirmatory tests are the currently available tools for diagnosis of UGTB. Recommendations are given on anti-tuberculous chemotherapy and surgery.