Epidemiology and risk factors for extrapulmonary tuberculosis in Lebanon
OBJECTIVE: The Lebanese National Tuberculosis Programme (NTP) sought to identify factors for the high proportion of EPTB and to assess the potential impact of Syrian refugees.
DESIGN: NTP line-listed data from 2014–2015 were analyzed with logistic regression identified risk factors for EPTB. A trend analysis for 2011–2015 assessed TB burden by nationality and site of TB.
RESULTS: Of 1347 reported TB cases from 2014 to 2015, 507 (38%) were EPTB and 46% were Lebanese. In analysis limited to Lebanese-born, the proportion of EPTB cases was relatively stable, 47% in 2011 and 52% in 2015. Modeling identified risk factors for EPTB as being female (aOR 1.79, 95%CI 1.39–2.32) and 5–15 years old (aOR 3.31, 95%CI 1.47–7.45) compared with children aged <5 years. Between 2011 and 2015, the proportion of TB cases among Syrian-born increased from 3% in 2011 to 21% in 2015 (P < 0.001); however, the proportion of EPTB versus PTB cases among Syrians remained stable (P = 0.264).
CONCLUSION: Syrian TB cases increased almost 10-fold in five years (2011–2015) but their contribution to EPTB did not change. The high proportion of EPTB in Lebanon and those aged 5–15 years merits further investigation.
Document Type: Research Article
Affiliations: 1: Emory University Rollins School of Public Health, Atlanta, GA 2: Centers for Disease Control and Prevention, Atlanta, GA, USA 3: National Tuberculosis Programme, Beirut, Lebanon
Publication date: April 1, 2020
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