Tuberculosis (TB) is a major public health concern worldwide and is the 13th leading cause of death and the second deadliest infectious disease after COVID-19. ¹ Extrapulmonary tuberculosis (EPTB) cases accounted for 16% of the 7.5 million cases of TB worldwide in 2019. ² global statistics indicate that Tuberculosis kills about 4,500 patient every day¹.
1. To know the epidemiology of extrapulmonary tuberculosis in Syria.
2. To know the effect of pulmonary tuberculosis risk factors on extrapulmonary tuberculosis.
3. To know the percentage of TB recurrence .
4. To know the percentage of non-adherence to tuberculosis treatment.
5. The comparison of the incidence of extrapulmonary tuberculosis over an 18-year period.
A retrospective study conducted at the National Center for Tuberculosis Control in Damascus and its countryside for the year of 2020 to analyze the patients with extrapulmonary tuberculosis .
205 patients were diagnosed with extrapulmonary tuberculosis in Damascus and its countryside in the year of 2020 and the sites of extrapulmonary tuberculosis were distributed as follows :
Lymph Nodes TB (102) 49.75% , peritoneal TB (28) 13.66% , pleural TB (26) 12.68% , spine TB (Pott's disease) (11) 5.36% , meningeal TB (8) 3.90% , skeletal TB (7) 3.41% , skin and soft tissue TB (5) 2.44% , genitourinary TB (5) 2.44% , gastrointestinal tuberculosis (5) 2.44% , pericardial TB (3) 1.46% , eye Tb (3) 1.46% , ENT Tb (1) 0.49% , breast TB (1) 0.49%
In diagnosing tuberculosis of the lymph nodes by biopsy the affected nodes were distributed as follows :
Cervical lymph nodes 80.40% , Axillary lymph nodes 6.86%. , Supraclavicular lymph nodes 4.90% , Submandibular lymph nodes 2.94% , Mesenteric nodes 2.94% , Mediastinal nodes 1.96%.
Most incidence rate was in patients between 25 and 34 years old , while the least incidence rate was in patients older than 65 years old . The percentage of infected females was approximately 66%, while the percentage of infected males was approximately 34% . The majority of infected patients were residents in the city (78.68%) compared to infected patients from the countryside (21.31%). The most common comorbidities among patients with extrapulmonary tuberculosis were:
Hypertension: 23.41% of cases , Diabetes Mellitus : 15.12% cases , Chronic obstructive pulmonary disease: 2.4% , Covid-19: 9.75% were diagnosed with COVID-19, 9 of which were confirmed by PCR testing, and 11 cases were diagnosed clinically . 17 of those infected with Covid-19 had lymph nodes tuberculosis, two had urogenital tuberculosis, and one case was with pleural tuberculosis . Possible risk factors were : Smoking: (cigarettes and hookah) 38.53% of extrapulmonary tuberculosis patients were smokers of cigarettes and waterpipes in addition to passive smokers, while 61.46% were non-smokers , Unhealthy housing: 23.41% of patients live in an unventilated or unsunny houses , Forced displacement: 20.97% of all patients which forced them to live in crowded and unhealthy places , cases of relapse: 12 cases of recurrence (5.85%) , cases of non-adherence to tuberculosis treatment: 9 cases (4.39%) , Prisoners : 6 cases (2.92%). The most common general symptom associated with extrapulmonary tuberculosis was fever 55.60%, while night sweats was the least common symptom 14.63% .
Tuberculosis is a major public health concern worldwide that can cause death or cause long-lasting complications but still is a preventable and treatable disease that’s why disease prevention , early diagnosis and early treatment are vital.