[Extrapulmonary tuberculosis. Experience at a general hospital (1980-1993)]

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Epidemiology

Context:

• Extrapulmonary tuberculosis (EPT) diagnosis relies on mycobacterial culture analysis.
• The study period spans 1980-1993, encompassing significant changes in tuberculosis epidemiology.
• HIV co-infection emerged as a major factor influencing disease presentation.

Purpose:

• To analyze trends in extrapulmonary tuberculosis (EPT) incidence and clinical manifestations.
• To compare the distribution of EPT sites between two distinct time periods (1980-1985 and 1986-1993).
• To investigate the influence of HIV status on EPT presentation.

Summary:

• A total of 290 EPT cases were diagnosed, with a notable increase in incidence from 101 cases (1980-1985) to 189 cases (1986-1993).
• Significant shifts in common infection sites were observed: genitourinary (42.6%) pre-1985, versus pleural (22.8%), genitourinary, and lymphatic (22.2% each) post-1985.
• The study identified a decrease in genitourinary EPT (p=0.00004) and increases in disseminated (p=0.015) and pleural (p=0.011) forms after 1985.
• Disseminated EPT increased in HIV-positive patients (p<0.0001), while genitourinary and pleural forms rose in HIV-negative patients.

Impact:

• The findings highlight a concerning rise in extrapulmonary tuberculosis, independent of HIV status.
• Changes in clinical presentation underscore the evolving nature of tuberculosis and the need for adaptable diagnostic and treatment strategies.
• This research provides crucial epidemiological data for public health interventions targeting tuberculosis control.