Hammami Fatma, Koubaa Makram, Ben Ayed Houda, Rekik Khaoula, Ben Jemaa Maissa, Ben Hmida Mariem, Trigui Maroua, Marrakchi Chakib, Dammak Jamel, Ben Jemaa Mounir
MD, Infectious Diseases Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia.
MD, Community Health and Epidemiology Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia.
Germs. 2020 Sep 1;10(4):150-156. doi: 10.18683/germs.2020.1200. eCollection 2020 Sep.
Tuberculosis affects commonly the lungs, but any other organs can be affected as well. Urogenital tuberculosis is usually misdiagnosed. In this perspective, we aimed to give an update on the epidemiological, clinical and evolutionary features of urogenital tuberculosis in Southern Tunisia.
We conducted a retrospective study including all patients with extrapulmonary tuberculosis notified during the period from 1992 to 2017 in Southern Tunisia. We specified the particularities of urogenital tuberculosis cases, and we compared them with other extrapulmonary tuberculosis cases.
Overall, we analyzed 240 cases with urogenital tuberculosis, among 1702 patients with extrapulmonary tuberculosis (14.1%). There were 121 women (50.4%). The mean age was 49±17 years. Multifocal tuberculosis was noted in 29 cases (12.1%). There were 169 cases with urinary tract tuberculosis (70.4%). Chronological trends analysis showed that the median age at diagnosis increased significantly (Rho=0.41; p=0.039) and the number of urogenital tuberculosis declined during the study period, without a statistical significance (Rho = -0.07; p=0.721). Compared to other extrapulmonary tuberculosis sites, patients aged 60 years and above (OR=2.7; p<0.001) and coming from rural areas (OR=1.4; p=0.021) were more frequently diagnosed with urogenital tuberculosis. Treatment duration was significantly longer in patients with urogenital tuberculosis (10.13±3.79 vs 9.20±3.77 months; p<0.001). As for the disease evolution, relapse was significantly more frequent in patients with urogenital tuberculosis (OR=4.1; p=0.045).
Although decreasing trends over time were noted, the prognosis of urogenital tuberculosis was more severe compared to other extrapulmonary tuberculosis sites.
结核病通常累及肺部，但其他任何器官也可能受累。泌尿生殖系统结核常被误诊。从这个角度出发，我们旨在介绍突尼斯南部泌尿生殖系统结核的流行病学、临床及演变特征的最新情况。
我们进行了一项回顾性研究，纳入了1992年至2017年期间在突尼斯南部报告的所有肺外结核患者。我们明确了泌尿生殖系统结核病例的特殊性，并将其与其他肺外结核病例进行比较。
总体而言，我们分析了1702例肺外结核患者中的240例泌尿生殖系统结核病例（占14.1%）。其中有121名女性（占50.4%）。平均年龄为49±17岁。29例（占12.1%）为多灶性结核。有169例泌尿生殖道结核（占70.4%）。时间趋势分析表明，诊断时的中位年龄显著增加（Rho=0.41；p=0.039），且在研究期间泌尿生殖系统结核的病例数有所下降，但无统计学意义（Rho = -0.07；p=0.721）。与其他肺外结核部位相比，60岁及以上的患者（OR=2.7；p<0.001）和来自农村地区的患者（OR=1.4；p=0.021）更常被诊断为泌尿生殖系统结核。泌尿生殖系统结核患者的治疗时间明显更长（10.13±3.79个月对9.20±3.77个月；p<0.001）。至于疾病演变，泌尿生殖系统结核患者的复发明显更频繁（OR=4.1；p=0.045）。
尽管随着时间推移呈下降趋势，但与其他肺外结核部位相比，泌尿生殖系统结核的预后更为严重。
