Burden of Mycobacterium tuberculosis and Associated Factors among Presumptive Extra pulmonary Tuberculosis Patients from Selected Health Facilities, Addis Ababa, Ethiopia

Elias Alehegn; Alganesh Gebreyohanns; Bereket Berhane; Jayne Wright; Mengistu Fantahun; Michael Hailu; Bedo Buta; Melkayehu Kassa; Tsedale Woldu; Natnael Dejene; Nuhamen Zena; Tewodros Tesfaye; Azeb Gezahegn; Tilahun Getinet; Addisu Gize

doi:10.1016/j.ijregi.2023.03.007

Burden of Mycobacterium tuberculosis and Associated Factors among Presumptive Extra pulmonary Tuberculosis Patients from Selected Health Facilities, Addis Ababa, Ethiopia

IJID Reg. 2023 Mar 22:7:199-205. doi: 10.1016/j.ijregi.2023.03.007. eCollection 2023 Jun.

Authors

Elias Alehegn^{1

2}, Alganesh Gebreyohanns¹, Bereket Berhane¹, Jayne Wright³, Mengistu Fantahun¹, Michael Hailu⁴, Bedo Buta⁴, Melkayehu Kassa¹, Tsedale Woldu¹, Natnael Dejene¹, Nuhamen Zena¹, Tewodros Tesfaye⁵, Azeb Gezahegn⁵, Tilahun Getinet², Addisu Gize^{1

6}

Affiliations

¹ St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
² Addis Ababa City Administration, Farmers and Urban Agriculture Development Commission, Addis Ababa, Ethiopia.
³ Jayne Wright Ltd, Pathology Consultancy, UK.
⁴ Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
⁵ Ras Desta Damtew Memorial Hospital, Addis Ababa, Ethiopia.
⁶ CIH Center for International Health, University Hospital, LMU Munich, Germany.

Abstract

Background: Extra pulmonary tuberculosis (EPTB) accounts for a significant proportion of tuberculosis (TB), a devastating disease of public health concern. The complexity of the cases, the involvement of many organs, resource constraints, and concerns regarding drug resistance make disease diagnosis and treatment difficult. This study aimed to determine the burden of tuberculosis and associated factors among presumptive EPTB patients in selected hospitals in Addis Ababa.

Material and methods: A cross-sectional study was conducted from February to August 2022 in selected public hospitals in Addis Ababa. Those who attended the hospitals and were presumptively diagnosed as EPTB patient were included in the study. Sociodemographic and clinical data were collected using a semistructured questionnaire. The GeneXpert MTB/RIF assay, Mycobacterium Growth Indicator Tube (MGIT) culture, and solid culture using Löwenstein-Jensen (LJ) medium were used. The data were entered and analyzed using SPSS version 23, and a p-value ≤ 0.05 was considered as statistically significant.

Results: From a total of 308 participants enrolled in this study, the measured burdens of extrapulmonary tuberculosis using the Xpert MTB/RIF assay, liquid culture, and solid culture were 54 (17.5%), 45 (14.6%), and 39 (12.7%), respectively. In this study, sex, contact history with known TB cases, having a purulent type of aspirate, and being HIV positive had statistically significant associations with EPTB.

Conclusions: The burden of extrapulmonary tuberculosis among presumptive extrapulmonary tuberculosis cases was found to be significant. Sex, contact history with a known TB case, having apurulent type of aspirate, and being HIV positive were found to be associated with extrapulmonary tuberculosis infection. Strict adherence to the national tuberculosis diagnosis and treatment guidelines is important, while the true burden of the disease should be ascertained using standard diagnostic tests for better prevention and control interventions.

Keywords: Associated factors; Extra pulmonary tuberculosis; GeneXpert; Mycobacterial culture.