Prevalence of Tuberculosis in Patients Visiting Massawa Hospital: Cross-Sectional Study, 2021

Background: Despite the availability of efficacious drugs, tuberculosis remains a major public health problem in low- and middle-income countries. This study was aimed to determine the prevalence of tuberculosis in Massawa Hospital, Eritrea. Methods: Laboratory and medical records of tuberculosis patients in Massawa Hospital were reviewed. All patients who did sputum exam by Xpert Gene from January 01, 2018 to May 1, 2021 in Massawa Hospital were enrolled in this study. Categorical variables were presented in percent, frequencies, Chi-square test, and odds ratio with 95% confidence interval. P value <0.05 was considered significant. Results: Sputum examination was done on 2178 patients and the prevalence of bacteriologically positive tuberculosis was 7%. Moreover, the prevalence of rifampicin resistant tuberculosis among the total tested and bacteriologically positive patients was 0.4% and 5.9% respectively. The main reason for sputum examination was presumptive diagnosis of tuberculosis (85.5%). Tuberculosis spondylitis (15.6%) and adenitis (13.6%) were found to be the most common types of extra pulmonary tuberculosis. The prevalence of tuberculosis in HIV patients was 5.2% and all started highly active antiretroviral therapy. Patients aged 15 to 24 years were having higher prevalence of tuberculosis (8.8%, 95%CI 0.68-4.72, OR-1.79). And, those from Ghelaelo subzone were having about two times higher prevalence of tuberculosis (9.9%, 95%CI 1.39-3.06, OR-2.06). Patients who had previous history of tuberculosis were having about five times higher prevalence of tuberculosis (27.5%, 95%CI 2.65-11.17. OR-5.4, p<0.001) and Rifampicin resistant tuberculosis (9.1%, p<0.002). Conclusion: The prevalence of tuberculosis and the multidrug resistant tuberculosis among the confirmed cases was comparatively increased than the average WHO estimates for Eritrea and similar to a study conducted in Nakfa subzone, Eritrea. The prevalence of tuberculosis in HIV patients was higher to the WHO estimates and previous studies in the country. Previous history of tuberculosis was significantly associated with the prevalence tuberculosis and multidrug resistant tuberculosis. Further prospective studies to evaluate the national prevalence of tuberculosis and rifampicin resistant tuberculosis are highly recommended.