Epidemiologic pattern of tuberculosis infection in Menoufia Governorate, Egypt, and diagnostic accuracy of GeneXpert MTB/RIF resistance technique

Prevalence of Rifampicin resistance tuberculosis among presumptive tuberculosis patients in Egypt-2021: a national health facility-based survey

BACKGROUND

The magnitude of MDR-TB cases was noticeable in Egypt. However, the last national survey was 11-years ago. The current survey was conducted to determine the prevalence of rifampicin resistance among sputum smear-positive pulmonary tuberculosis patients in Egypt.

METHODS

A national health facility-based cross-sectional study was conducted in 14 randomly selected governorates in Egypt between August 2020 and September 2021. All presumptive TB cases, either new or previously treated according to WHO definitions, with no gender, age, or nationality limitations, and provided informed consent were included in the study. Each patient completed a case report form (CRF). The CRF included socio-demographic and clinical data. Sputum samples were collected according to standard techniques and cultured on Lowenstein-Jensen (L-J) medium. Gene X-pert test was carried out first on the samples for simultaneous identification of MTB and rifampicin resistance. The prevalence of RR was calculated using crude, cluster, and weighted methods. Factors associated with RR were analyzed by bivariate and multivariate techniques.

RESULTS

Among the total 849 presumptive TB patients enrolled in the study, 710 (83.6%) patients were subjected to Gene X-pert testing (MTB/RIF). The crude prevalence of RR was 3.32% (95% CI: 1.89-4.76%) among the new cases and 9.46% (95% CI: 2.63-16.29%) among the retreated cases with an overall estimate of 3.99%; (95% CI: 2.51-5.47%). By cluster analysis the overall prevalence of RR was 5.01% (95% CI: 2.90-7.13). Factors associated with the prevalence of RR were co-morbidity with bronchial asthma, drug abuse and history of contact with a family member with TB.

CONCLUSION

The prevalence of RR among either new or retreated cases TB patients was lower than the previous Egyptian rates in 2010-2012. The strongest predictor associated with RR was comorbidity with bronchial asthma.

The clinical and functional characteristics of bronchiectasis among tuberculosis patients in Upper Egypt: a single-center study

Background

Tuberculosis (TB) is considered one of the most common causes of bronchiectasis. Bronchiectasis increases clinical and financial burden of patients with TB. Here, we aim to assess the prevalence of bronchiectasis and its characteristics in patients with TB.

Results

Over 1 year duration, 85 patients with confirmed TB were enrolled in the study. Those patients were clinically, laboratory, and radiologically evaluated. Any patient with other chest diseases was excluded from the study. Out of those patients, 19/85 (22.4%) patients had bronchiectasis. It was found that patients with bronchiectasis had higher frequency of urban residence, current cigarette or goza smoking, and diabetes mellitus. Hemoptysis and expectoration were the most frequent symptoms. Pulmonary function tests were significantly impaired in patients with bronchiectasis. Disease burden was significantly higher among bronchiectasis group in form of frequent hospitalization, longer hospital stay, and need of oxygen therapy.

Conclusion

Bronchiectasis is not uncommon among TB patients. Co-existence of bronchiectasis with TB has distinctive clinical, and functional characteristics that increase the burden of the diseases in the form of prolonged hospital stay and higher utilization of antibiotics and oxygen therapy. Smoking in tuberculous patients may is significantly associated with bronchiectasis.

Trends in pattern of tuberculosis in Sharkia Governorate at Ministry of Health and Population Chest Hospitals from 2016 to 2019

Abstract

Background

Tuberculosis is a communicable disease that is one of the leading cause of death from a single infectious agent (ranking above human immunodeficiency virus/acquired immunodeficiency syndrome). The aim of this work was to study the trend of applying the tuberculosis control program at the ministry of health and population chest hospitals, Sharkia, Egypt.

Results

This retrospective cross-sectional study was carried out using medical records from the tuberculosis registry at Ministry of Health and Population chest hospitals, Sharkia Governorate. The investigated variables included demographic characteristics, type of tuberculosis infection, and affected organs. All data were coded and statistically analyzed. A total 1404 cases of tuberculosis were notified between 2016 and 2019 with male predominance, where 67.1% were males and 32.9% were females. The highest number of tuberculosis patients was from the reproductive age groups. During the 4-year study period, the highest percentage of cases was new cases and the highest frequency of cases was during 2017 and the lowest frequency was during 2016. There was a decline in the total number of cases in 2018 and 2019 after sharp increase of total cases in 2017: pulmonary tuberculosis cases showed a sharp decline in 2017; however, there was an increase in extrapulmonary tuberculosis cases during 2017 then a slight decrease in 2018 and 2019. Of the pulmonary tuberculosis cases, 83.8% were smear-positive tuberculosis.

Conclusions

Pulmonary smear-positive and new cases were the most common among the recorded cases of tuberculosis. Productive age groups represented large percentage of the studied cases of tuberculosis. Lymph node and bones were the most common sites of extrapulmonary tuberculosis among reported cases in this study.