The Spectrum of Tuberculosis among Patients in Saudi Arabia

A retrospective study, reviewing the medical records of 157 patients with a final diagnosis of tuberculosis on discharge, was conducted at King Abdul Aziz University Hospital during the period July 1999 to July 2001. The data included demographic characteristics, the spectrum of clinical presentations, diagnostic methods, and the outcome of treatment. A total of 157 patients were admitted with tuberculosis; their median age was 33(± 15.33) years. Fifty-seven (36%) were Saudis and 100 (64 %) were non-Saudis. Pulmonary tuberculosis and pleural effusion were the commonest presentations (37.6%). Diagnosis was confirmed in most cases by either a positive sputum smear for AFB or by pleural biopsy; in five patients the diagnosis was made on clinical grounds and pleural fluid analysis. There was a wide spectrum of extra-pulmonary tuberculosis, diagnosed histologically except in five cases, in which treatment was started empirically based on high clinical suspicion and a strongly positive tuberculin test. Correspondance: Dr Faiza A Qari, Medical Department, KAUH, PO Box 13042, 21943 Jeddah, Saudi Arabia. Fax: ++6743781 E-mail: [email protected] INTRODUCTION Tuberculosis (TB) is a major worldwide public health problem. The failure to eliminate TB, a curable and preventable disease, is the result of many factors: the nature of the tubercle bacillus, which remains dormant for an extended period of time; poor patient compliance with long-term treatment; the continued immigration of infected people from endemic countries, misdiagnosis by physicians; the lack of affordable treatment (Al Hajjaj et al, 1991; Raviglion et al, 1995). The pattern of disease may be modified by socioeconomic, genetic, dietary, and other poorly understood factors. During the last two years, a total of 157 patients with TB were admitted to the King Abdul Aziz University Hospital, Jeddah; this study reviews the spectrum of clinical presentation, diagnostic methods, and treatment outcomes. MATERIALS AND METHODS King Abdul Aziz University Hospital is a government teaching hospital in Jeddah, Saudi Arabia. One hundred and fifty-seven patients were admitted either to medical or surgical wards with a final diagnosis of tuberculosis during the two-year period of July 1999 to July 2001. Medical records were reviewed; the following data were collected: age, sex, nationality, site of TB (pulmonary or extrapulmonary), clinical presentation, diagnostic methods (eg ESR, PPD, radiology, fluid aspiration, histopathology), treatment, and treatment outcome. Statistical analysis was carried out using SPSS (Statistical Package for Social Science) 7.5. Results were presented as means (± SD) or as percentages.