Trends in extrapulmonary TB cases at three teaching hospitals in Ghana, 2008–2017

So, Addo; Gi, Mensah; Mosi, Lydia; Abrahams, Afua O.D.; Bonfoh, Bassirou; Kazwala, R. R.; Zinsstag, J; Kk, Addo

doi:10.5588/pha.20.0061

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…The current study also found a high prevalence of EPTB, with almost half (48%) of the TB population diagnosed with EPTB. This was higher than reported rates of 29% and 20-30%, respectively, in previous local studies [21,22]. A similar study in a referral hospital in Ethiopia reported an EPTB proportion of 49.8% [27].…”

Section: Discussioncontrasting

confidence: 60%

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The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

Afriyie-Mensah,

Aryee,

Zigah

et al. 2023

Tuberculosis Research and Treatment

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Aim. We aimed to investigate the demographic and clinical factors associated with TB mortality in patients managed at a tertiary TB referral center. Methods. We conducted a retrospective review of the medical records of 1,933 TB patients seen between January 2017 and December 2020 at the Korle-Bu Teaching Hospital (KBTH) Chest Department in Accra, Ghana. TB mortality was defined as any TB patient who died for any reason during the course of treatment. Multivariable logistic regression was used to estimate adjusted odds ratios with 95% confidence intervals for factors associated with TB mortality. Results. A total of 1,933 patients with TB were registered at the chest clinic over the study period. Males accounted for 1,227 (63.5%), and majority of participants were between 24 and 64 years old. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) cases accounted for 51% and 48.4% of the total TB cases, respectively. A significant proportion (69%) of the patients managed for TB had no bacteriological confirmation of the disease. About 34% of tested TB patients were HIV positive. Mortality among patients was 33.6%. In a multivariable regression model, patients with HIV positive status had over 3-fold increased risk of mortality, compared to those with HIV negative status. TB patients diagnosed empirically had an increased risk of death compared to those with a confirmed diagnosis. Conclusion. The proportion of clinically diagnosed TB was high among the patients seen at the chest clinic. Mortality was high among the patients with HIV/TB coinfection as well as in patients with empirical TB diagnosis.

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Section: Discussioncontrasting

confidence: 60%

“…The cohort of TB patients reviewed was largely male, which has been observed in several studies involving TB patients [21][22][23]. The male-to-female ratio was estimated to be 1.6 : 1 by WHO although variable across countries [24].…”

Section: Discussionmentioning

confidence: 99%

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

Afriyie-Mensah,

Aryee,

Zigah

et al. 2023

Tuberculosis Research and Treatment

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“…The risk of developing active TB disease is 20 to 37 times greater in HIV-infected persons than in HIV-uninfected persons [7]. In most high-burden TB/HIV countries, including Ghana, many of the estimated new TB cases are un-notifiable [8]. Only 64% of the estimated 10 million new TB cases in HIV-uninfected persons and A share 51% of the estimated 0.9 million new TB cases in HIVinfected persons were reported in 2017 [2].…”

Section: Introductionmentioning

confidence: 99%

Determinants of sputum ordering for tuberculosis diagnosis in people living with HIV in the Greater Accra Region, Ghana

2022

HSI Journal

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Background: This study assessed factors associated with sputum ordering for tuberculosis (TB) diagnosis in people living with HIV (PLHIV) who were screened positive for TB in three hospitals providing HIV care and treatment services in the Greater Accra region of Ghana.Objective: This study assessed the factors associated with sputum ordering in PLHIV with a positive TB symptom screen test.Methods: A mixed-method cross-sectional study was undertaken at three hospitals providing HIV care and treatment services in the Greater Accra region of Ghana. The study involved a review of 400 patients' charts and in-depth interviews with health workers involved in the care and treatment of PLHIV. Bivariate analysis using a Chi-square test and Logistic regression for multivariate analysis were used to establish factors associated with sputum ordering. Factors having a p ≤ 0.05 were considered significantly associated with sputum ordering. Inductive thematic analysis was used to explain the associated factors. Results:Of the 400 charts reviewed, 67.7% were female patients with a median age of 39 (IQR 31 ̶ 49). TB screening was recorded in 78% (n = 312/400, 95% CI: 73.6 ̶ 82.0) of the patients, of whom ninety-two (92) patients had a positive TB screen test. Only 57.6% (n = 53) who had a positive screen test had sputum ordered for further TB testing. In the multivariate analysis, the patient's general appearance was described as abnormal (OR = 3.05, p = 0.036), having more than one TB symptom (OR = 3.42, p = 0.028) and presence of an alternative presumptive diagnosis (OR = 0.34, p = 0.023) were associated with having a sputum test ordered. High patient numbers, the inability to produce sputum, the unwillingness of moderately sick patients to provide sputum and the cost associated with chest X-rays were perceived as the challenges to further testing for TB. Conclusion:Almost half of PLHIV with a positive TB screen test did not have a sputum test documented. This calls for instituting measures to address the barriers to TB screening among people living with HIV/AIDS for effective TB and HIV comorbidity management.

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Utility of anti-Mycobacterium tuberculosis antibody (ab905) for detection of mycobacterial antigens in formalin-fixed paraffin-embedded tissues from clinically and histologically suggestive extrapulmonary tuberculosis cases

Addo¹,

Abrahams²,

Mensah³

et al. 2022

Heliyon

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Trends in extrapulmonary TB cases at three teaching hospitals in Ghana, 2008–2017

Cited by 5 publications

References 19 publications

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

Determinants of sputum ordering for tuberculosis diagnosis in people living with HIV in the Greater Accra Region, Ghana

Utility of anti-Mycobacterium tuberculosis antibody (ab905) for detection of mycobacterial antigens in formalin-fixed paraffin-embedded tissues from clinically and histologically suggestive extrapulmonary tuberculosis cases

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