Mucheleng'anga Luchenga Adam, Himwaze Cordilia M, Telendiy Viktor, Simumba Suzyani, Soko Jonathan, Kayonde Nathan, Mulenga Bwalya, Hamukale Amos, Shibemba Aaron Lunda, Lungu Patrick S, Tembo John, Bates Matthew, Chanda-Kapata Pascalina, Mwaba Peter, Kapata Nathan, Ntoumi Francine, Zumla Alimuddin
Office of the State Forensic Pathologist, Zambia Ministry of Home Affairs, Lusaka Zambia; UNZA School of Medicine, Lusaka, Zambia; PANDORA-ID-NET Pathogenesis Group, and UNZA-UCLMS Research and Training Program*. University Teaching Hospital, Lusaka, Zambia.
Office of the State Forensic Pathologist, Zambia Ministry of Home Affairs, Lusaka Zambia; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia; PANDORA-ID-NET Pathogenesis Group, and UNZA-UCLMS Research and Training Program*. University Teaching Hospital, Lusaka, Zambia.
Int J Infect Dis. 2022 Nov;124 Suppl 1:S75-S81. doi: 10.1016/j.ijid.2022.03.005. Epub 2022 Mar 11.
Tuberculosis remains a global emergency. In Zambia only 55% of tuberculosis cases are diagnosed. We performed a study to determine incidental cases of tuberculosis seen at forensic autopsy of individuals who died suddenly and unexpectedly in the community in Lusaka, Zambia.
Whole-body autopsies were performed according to Standard Operating Procedures. Representative samples obtained from relevant organs were subjected to pathological examination. Information on circumstances surrounding the death was obtained. Data on patient demographics, gross and microscopic pathological findings, and cause(s) of death were analysed.
Incidental tuberculosis was found in 52 cases (45 male, 7 female, age range 14-66) out of 4286 whole-body autopsies. 41/52 (80%) were aged 21-50 years. One was a 14-year old boy who died during a football match. 39/52 (75%) deaths were attributable specifically to tuberculosis only. Other deaths were due to acute alcohol intoxication(4), violence(7), ruptured ectopic pregnancy(1), bacterial meningitis (1). All the cases were from poor socio-economic backgrounds and lived in high-density areas of Lusaka.
Incidental cases of active tuberculosis undiagnosed antemortem seen at forensic autopsy reflects major gaps in the national TB control programs. More investments into proactive screening, testing, treatment activities, and accurate data collection are required.
结核病仍然是一个全球紧急情况。在赞比亚，只有55%的结核病病例得到诊断。我们开展了一项研究，以确定在赞比亚卢萨卡社区突然意外死亡个体的法医尸检中发现的结核病偶发病例。
按照标准操作程序进行全身尸检。从相关器官获取代表性样本进行病理检查。获取有关死亡周围情况的信息。分析患者人口统计学数据、大体和微观病理检查结果以及死亡原因。
在4286例全身尸检中，发现52例（男性45例，女性7例，年龄范围14 - 66岁）偶发结核病。41/52（80%）年龄在21 - 50岁之间。其中1例是一名在足球比赛中死亡的14岁男孩。39/52（75%）的死亡仅具体归因于结核病。其他死亡原因包括急性酒精中毒（4例）、暴力（7例）、异位妊娠破裂（1例）、细菌性脑膜炎（1例）。所有病例均来自社会经济背景较差且居住在卢萨卡高密度地区的人群。
法医尸检中发现的生前未诊断出的活动性结核病偶发病例反映了国家结核病控制项目中的重大差距。需要对主动筛查、检测、治疗活动以及准确的数据收集进行更多投资。
