Factors associated with localization of tuberculosis disease among patients in a high burden country: A health facility-based comparative study in Ethiopia. (May 2021)

• Record Type: Journal Article
• Authors: Taye, Hawult; Alemu, Kassahun; Mihret, Adane; Wood, James L.N.; Shkedy, Ziv; Berg, Stefan; Aseffa, Abraham
• Is Part Of: Journal of clinical tuberculosis and other mycobacterial diseases. Volume 23(2021)
• Publication Date: 2021-05
• Subjects: Tuberculosis -- Clinical disease category -- Associated factors; Tuberculosis -- Periodicals; Mycobacterial diseases -- Periodicals; 616.995
• DOI: 10.1016/j.jctube.2021.100231
• Languages: English
• ISSNs: 2405-5794

Abstract

Highlights: A steady high rate of cervical tuberculous lymphadenitis (TBLN) has been reported in Ethiopia. That was significantly associated with biological factors that include age and sex of individuals. The risk of developing TBLN also related with chronic medical conditions such as renal disease. Suggests that specific symptom based screening may lead to missing a significant portion of cases. Hence, lymph node enlargement should be considered in the national case screening program. Abstract: Introduction: In contrast to most tuberculosis (TB) high burden countries, Ethiopia has for a long time reported a very high percentage of extra pulmonary TB (EPTB), which is also reflected in population based estimations reported by the World Health Organization (WHO). Particularly a steadily higher proportion of cervical tuberculous lymphadenitis (TBLN) has been described. Here we identify clinical and demographic factors associated with anatomic site of the TB disease. Method: A health facility based comparative study was conducted among TBLN and PTB patients who visited selected health facilities in Ethiopia during 2016 and 2017. Associated risk factors were identified through a multivariate logistic regression model using R-studio. Result: A total of 1, 890 study participants, 427 TBLN and 1, 463 PTB patients, were included. The mean age of TBLN patients (29 years ± 14.4 SD) was lower than that of PTB cases (36 years ± 15.0 SD). There were slightly more women diagnosed with TBLN (51.1%) while nearly 6 out of 10 male patients were diagnosed with PTB (58.9%). Most significantly, younger age groups (<15 Years) were more likely to develop cervical TBLN than older people (>56 years), with an AOR of 9.76 (95% CI: 4.87, 19.56). The odds of cervical TBLN among women [1.69 (1.30, 2.20)] was higher than that for men. In addition, adjusted estimates suggested that, compared with PTB, renal diseases [3.41 (1.29, 9.02)] and the presence of other concomitant chronic illness [1.61 (1.23, 2.09)] had a significant association with TBLN. Conclusion: Generally, the risk of developing a particular form of TB disease is usually associated with demographic and medical history of an infected individual. Hence, the current symptom based screening, which primarily rely on chronic cough in many countries, may lead to missing significant portions of TBLN cases.