Tuberculosis in Ibadan, Nigeria--a 30 year review

Recent reports have indicated a re-emergence of tuberculosis (TB) worldwide, particularly in the USA, where this re-emergence has been attributed mainly to immunosuppression by HIV. Information on the pattern and trend of TB is scarce in the developing countries, including Nigeria. This present study was set out to review the pattern of TB in the University College Hospital (UCH), Ibadan, between 1966 to 1995 with emphasis on changing trend between two time periods: 1966 to 1980 and 1981 to 1995.

A 30 year retrospective review of all cases of tuberculosis diagnosed from surgical pathology and autopsy in the Department of Pathology, UCH, Ibadan, between January 1966 and December 1995 was done. The age, sex, details of organ involvement and biopsy site of the cases were studied and the data obtained was tabulated and analysed statistically.

Tuberculosis in this environment affects predominantly individuals below 40 years of age with peak age frequency between 21 to 30 year age range. More females are affected with TB with twice as many females as males being affected in the reproductive years. There were significant declines in tuberculous involvement of the female genital tract, bone and skin in the second period 1981 to 1995 compared to the first period 1966 to 1980. The frequency of miliary TB remained high in the second period. Deaths from tuberculosis were highest in the age group zero to 10 years, with deaths in all age groups being due to disseminated TB and TB meningitis.

Socio-economic factors and poor health care facilities rather than HIV appear to be more important contributing factors to the gradual increase in the frequency of tuberculosis in the second period of this study.