A RETROSPECTIVE OBSERVATIONAL STUDY OF THE CLINICAL FEATURES OF EXTRAPULMONARY TUBERCULOSIS IN THE DAMASCUS, SYRIA

Ahmad Al Jbawi*, Mohammad Fadel, Michel Najjar, Sara Albuaini, Fares Kahal and Yser Mohammad MD

ABSTRACT

Background: Tuberculosis (TB) is a major public health concern worldwide and is the 13th leading cause of death, and the second deadliest infectious disease after COVID-19 worldwide. Extrapulmonary tuberculosis (EPTB) cases accounted for 15% of the 7.2 million cases of TB worldwide in 2019. Global statistics indicate that Tuberculosis causes 4,500 deaths every day.[1] We aim to study the epidemiology of EPTB and studying the various symptoms and Comorbidities for pulmonary and extrapulmonary tuberculosis and their risk factors. Methods: A multicenter retrospective study was conducted at the National Center for Tuberculosis Control in Damascus in the year 2020 to analyze the patients with extrapulmonary tuberculosis. All patients diagnosed with EPTB in 2020 in Damascus were included. 205 patients diagnosed with pulmonary TB in 2020 in Damascus were randomly included to study the association of pulmonary TB risk factors and EPTB. Results: 205 patients were diagnosed with extrapulmonary tuberculosis in Damascus and its countryside in the year 2020, and the most common site of infection was Lymph Nodes (102) 49.75%, while ear and breast were the least common (1 case of each). Cervical nodes were the most affected nodes with EPTB (80.40%), while mediastinal nodes were the least affected (1.96%). The highest incidence rate was in patients between 25 and 34 years old, while the lowest was in patients older than 65. The percentage of infected females was approximately 66%, while the percentage of infected males was approximately 34%. The majority of infected patients were residents of the city (78.68%) compared to infected patients from the countryside (21.31%). The most common comorbidity was Hypertension: 23.41% of Extrapulmonary TB cases and 33.2% of pulmonary cases, while kidney diseases were the least common in both. EPTB was associated with female gender and rural residence with a statistically significant relationship (P-value<0.05), while Pulmonary TB associated with male gender and smoking. The most common general symptom associated with extrapulmonary tuberculosis was fever 55.60%, while night sweats were the least common symptom 14.63%. Conclusion: Tuberculosis is a major public health concern worldwide that can cause death or cause long-lasting complications but can still be prevented by vaccination and avoiding the possible risk factors identified in this study.

Keywords: Tuberculosis, Extrapulmonary Tuberculosis, TB, EPTB, Epidemiology, Damascus, Syria, Multicenter, Retrospective.