Tuberculosis in Calabar: a ten-year review (1994-2003)

The aim of the study is to determine the pattern of tuberculosis as seen in Calabar over 10 years (1994-2003).

A ten-year retrospective study (1994-2003) was carried out to evaluate the pattern of tuberculosis among subjects in Calabar, Nigeria. A total of 6,737 cases of confirmed pulmonary and extrapulmonary tuberculosis seen during the period of survey were reviewed. The cases were drawn from the Infectious Disease hospital (IDH) Calabar, University of Calabar teaching hospital (UCTH), and TBL unit of the Ministry of Health, Calabar. Subjects, apart from being symptomatic were confirmed to have Pulmonary Tuberculosis (PTB) by Ziehl-Neelsen's sputum staining technique. Positive confirmation was attained if a patient's sputum was positive for acid fast bacilli on at least two separate times in line with the World Health Organisation's (WHO's) recommendation. In addition, some patients had chest radiograph, and those with evidence of pleural effusion were confirmed by pleural aspirate. However, cases with extrapulmonary tuberculosis (EPTB) were considered separately and the site of the lesions noted.

The results revealed some progressive yearly increase in the number of tuberculosis [TB] cases over the 10-year period with more children being diagnosed. Tuberculosis of the spine was the most common type of extrapulmonary tuberculosis among the patients with EPTB. The treatment outcome over the period was not satisfactory with a cure rate of 57% and a mean mortality rate of 14% (with a range of 12% to 17%), and a default rate of 18%.

The implication is that either the available tools are not properly utilized or extra-measures will be required to contain the scourge. We therefore recommend an increased supervision of the intensive phase of therapy and provision of facilities for culture and drug sensitivity testing at treatment centres, in case drug resistance is a factor.