Background Tuberculosis (TB) remains a public health problem in the Kingdom of Saudi Arabia (KSA), which has a very large labour force from high TB endemic countries. Understanding the epidemiological and clinical features of the TB problem, and the TB burden in the immigrant workforce, is necessary for improved planning and implementation of TB services and prevention measures. Methods A 10 year retrospective study of all TB cases reported in KSA covering the period 1st January 2000 to 31st December 2009. Data was obtained from TB reporting forms returned to the Ministry of Health. Data were then organised, tabulated and analysed for annual incidence rates by province, nationality, country of origin and gender. Results There was an annual increase in the number of TB cases registered from 3,284 in 2000 to 3,964 in 2009. Non-Saudis had nearly twice the TB incidence rate compared to Saudis (P = <0.05). All but four provinces (Najran, Riyadh, Makkah, Tabuk) showed decreasing TB incidence rates. The highest rates were seen in the 65+ age group. In the 15–24 year age group the incidence rate increased from 15.7/100,000 in 2000 to 20.9/100,00 in 2009 (P = <0.05). The incidence of TB in Saudi males was higher than Saudi females. Conversely, for non-Saudis the TB incidence rates were significantly higher in females compared to males. Conclusions Despite significant investments in TB control over 15 years, TB remains an important public health problem in the KSA affecting all age groups, and Saudis and non-Saudis alike. Identification of the major risk factors associated with the persistently high TB rates in workers migrating to KSA is required. Further studies are warranted to delineate whether such patients re-activate latent Mycobacterium tuberculosis (M.tb) infection or acquire new M.tb infection after arrival in KSA. Appropriate interventions are required to reduce TB incidence rates as have been implemented by other countries.

BACKGROUND AND OBJECTIVESTuberculosis (TB) still contributes to deaths in Saudi Arabia, among both Saudis and non-Saudis. Exploring the trend of deaths caused by TB and determinants associated with high fatality rate among TB patients is considered as a part of monitoring and evaluation of the performance of National Tuberculosis Control Program to help planners improve policies and procedures used to achieve the targets of TB control.DESIGN AND SETTINGSThe current study is a retrospective one, which used the official notifications of NTP in Saudi Arabia over a period of 10 years (2001–2010).METHODSA 10-year retrospective study included all TB cases registered in Saudi Arabia with known outcome of survival or death while under anti-TB therapy covering the period January 1, 2001, to December 31, 2010.RESULTSMortality among TB patients show a declining trend among Saudis starting from the year 2003 (7.2%–6.1%) and a stagnant trend among non-Saudis. Saudi nationality was associated with higher fatality rate compared to non-Saudis (6.4% and 5.4%, respectively). Mortality was positively correlated with advancing age, male sex among Saudis (7.3% compared to 5.3% among females), and female sex among non-Saudis (6% compared to 5% among males), prior history of anti-TB therapy, smear positivity, and human immunodeficiency virus (HIV) seropositivity.CONCLUSIONSWe recommend WHO to modify the definition of death among TB patients. We recommend NTP in Saudi Arabia to adopt and implement International Classification of Diseases (ICD10) for TB patients’ registration, improve health care services provided for elderly, monitor and strengthen NTP performance to decrease defaulter and early detect and treat patients, initiate a collaborative TB/HIV activities, and screen all suspected TB patients for HIV. In addition to these, more extended research has to be initiated concerning delayed diagnosis and comorbidities with TB.

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