The pattern of tuberculosis in Addis Ababa, Ethiopia

Two hundred and forty available charts of medical patients treated for tuberculosis at Tikur Anbessa Hospital in Addis Ababa, Ethiopia over 2 years (9/83-9/85 were studied. TB was diagnosed in 11.2% of medical admissions. The average age of TB patients was 30.5; 58% were males; 53% were classed as poor. TB patients were poorer than other medical patients and averaged 38.9 days in hospital, non-TB patients averaged 31.9 days. Pulmonary disease was most common (47% of total), followed by spondylitis (12.1%), peritonitis (11.5%), and disseminated disease (11.1%). There were no cases of renal or cutaneous disease. 6% of admissions were diabetic, 16.4% had defaulted from previous TB treatment. Only 45% of patients had the diagnosis proven by histology or bacteriology. Pleural biopsy, lymph node biopsy, peritoneal biopsy, and sputum AFB stain were the most useful procedures in proving the diagnosis. A variety of drugs were given, 53% received INH-EMB-SM, 26% INH-SM-Thiacetazone; 32% received no form of vitamin supplements. The overall death rate was 8%, including 9% of pulmonary cases and 22% of patients with disseminated disease. Comparison is made with Ethiopian and other African data. It is suggested that patients receive definitive diagnostic tests earlier, along with earlier therapy and more consistent use of pyridoxine.