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. 2020 Sep 1;10(4):150-156.
doi: 10.18683/germs.2020.1200. eCollection 2020 Sep.

Update on urogenital tuberculosis in Southern Tunisia: a review of a 26-year period

Fatma Hammami  1 , Makram Koubaa  1 , Houda Ben Ayed  2 , Khaoula Rekik  1 , Maissa Ben Jemaa  3 , Mariem Ben Hmida  3 , Maroua Trigui  3 , Chakib Marrakchi  1 , Jamel Dammak  3 , Mounir Ben Jemaa  1
Affiliations

Update on urogenital tuberculosis in Southern Tunisia: a review of a 26-year period

Fatma Hammami et al. Germs. .

Abstract

Introduction: 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.

Methods: 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.

Results: 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).

Conclusions: Although decreasing trends over time were noted, the prognosis of urogenital tuberculosis was more severe compared to other extrapulmonary tuberculosis sites.

Keywords: Antitubercular therapy; disease evolution; epidemiology; urogenital tuberculosis.

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Conflict of interest statement

Conflicts of interest: All authors – none to declare.

Figures

Figure 1
Figure 1. Chronological trends of urogenital tuberculosis new cases between 1992 and 2017
Figure 2
Figure 2. Chronological trends of age at diagnosis of patients with urogenital tuberculosis between 1992 and 2017
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