Trends in extrapulmonary TB cases at three teaching hospitals in Ghana, 2008–2017
OBJECTIVE: To elucidate trends in demographics, clinical characteristics and treatment outcomes in extrapulmonary TB (EPTB) patients.
DESIGN: This was a retrospective study involving the review and comparison of EPTB and pulmonary TB (PTB) data from 1 January 2008 to 31 December 2017 in TB registers and treatment cards.
RESULTS: Of 15,392 TB cases, 4607 (30%) were EPTB, including 4477/4607 (97%) new cases. There were 2,679/4607 (58%) males and the age range was 0.3 to 96 years. Pleural TB (1021/4607, 22%) was the most common. Treatment success rates for EPTB and PTB were respectively 72% and 84%. HIV positivity was high among patients with disseminated/miliary TB (429/779, 55%) and TB meningitis (242/526, 46%). To note, disseminated/miliary TB (χ2 = 33.53, P < 0.0001) increased, whereas TB meningitis (χ2 = 19.43, P < 0.0001) decreased over the 10-year period. Mortality among EPTB patients was associated with increasing age (25 years), disseminated/miliary TB, TB meningitis and HIV positivity.
CONCLUSIONS: There is male preponderance for both EPTB and PTB in Ghana. Increasing age, disseminated/ miliary TB, TB meningitis and HIV are risk factors for mortality among EPTB patients. This emphasises the need for public education on the risk factors for EPTB and preventive strategies.
Keywords: EPTB; TB register; retrospective study; treatment outcomes
Document Type: Research Article
Affiliations: 1: Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana, West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana 2: Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana 3: Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana, West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana 4: Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana 5: Centre Suisse de Recherches Scientifique en Cote d’Ivoire, Abidjan, Cote d’Ivoire 6: Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania 7: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
Publication date: March 21, 2021
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