Addo S O, Mensah G I, Mosi L, Abrahams A, Bonfoh B, Kazwala R, Zinsstag J, Addo K K
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.
Public Health Action. 2021 Mar 21;11(1):26-32. doi: 10.5588/pha.20.0061.
Three teaching hospitals in Ghana.
To elucidate trends in demographics, clinical characteristics and treatment outcomes in extrapulmonary TB (EPTB) patients.
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.
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 (χ = 33.53, < 0.0001) increased, whereas TB meningitis (χ = 19.43, < 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.
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.
加纳的三家教学医院。
阐明肺外结核病（EPTB）患者的人口统计学、临床特征及治疗结果的趋势。
这是一项回顾性研究，涉及对2008年1月1日至2017年12月31日结核病登记册和治疗卡中EPTB和肺结核（PTB）数据的审查与比较。
在15392例结核病病例中，4607例（30%）为EPTB，其中包括4477/4607（97%）新病例。男性有2679/4607（58%），年龄范围为0.3至96岁。结核性胸膜炎（1021/4607，22%）最为常见。EPTB和PTB的治疗成功率分别为72%和84%。播散性/粟粒性结核病患者（429/779，55%）和结核性脑膜炎患者（242/526，46%）的HIV阳性率较高。需要注意的是，在这10年期间，播散性/粟粒性结核病（χ = 33.53，P < 0.0001）有所增加，而结核性脑膜炎（χ = 19.43，P < 0.0001）有所减少。EPTB患者的死亡率与年龄增加（⩾25岁）、播散性/粟粒性结核病、结核性脑膜炎及HIV阳性有关。
在加纳，EPTB和PTB患者中男性居多。年龄增加、播散性/粟粒性结核病、结核性脑膜炎及HIV是EPTB患者死亡的危险因素。这凸显了对EPTB危险因素及预防策略进行公众教育的必要性。
