Extrapulmonary tuberculosis in Western Sudan during the armed conflict 2023-2024

Abstract

Background: Tuberculosis represents one of the foremost infectious cause of mortality globally; the disease is endemic in Sudan and has experienced a significant increase amid the ongoing armed conflict. This study aims to investigate extrapulmonary tuberculosis in Western Sudan during the conflict period from 2023 to 2024.

Methodology: A descriptive retrospective study was conducted at El-Obeid Teaching Hospital in North Kordofan State, Sudan, from August 2023 to September 2024. This was conducted on 233 patients diagnosed with extrapulmonary tuberculosis from a total of 751 patients with tuberculous infections. The study collected all data related to the patients from the hospital records during the specified period from 15 April 2023 to 15 April 2024. A total coverage of all patients diagnosed   with extrapulmonary tuberculosis within the designated time frame, irrespective of any inclusion or exclusion criteria. Results: The data revealed that 65% were males and 35% were females. The most prevalent age group is > 46, followed by < 18, 26-35, and 36-45, with incidence rates of 37%, 18%, 17%, and 13%, respectively. The majority of the patients (59%) lived in urban areas, while 41% in rural areas.63% of them were married, while 35% were single. Tuberculous lymphadenitis was the most prevalent type of extrapulmonary tuberculosis, followed by tuberculous pleuritis, abdominal TB, spinal TB, tuberculous pericarditis, and TB meningitis (39%, 28%, 14%, 12%, 5%, and 2%, respectively). Conclusion: Extrapulmonary tuberculosis is widespread in western Sudan, with tuberculous lymphadenitis and tuberculous pleuritis being the most common manifestations of the disease. This study indicates greater values than what was previously recorded in the world. In Western Sudan the disease primarily affects middle-aged males, with the majority of cases presented beyond the 2 months period. The near-collapsed economy, the inadequately equipped health system, and the detrimental effects of the armed conflict were the primary factors in the study's findings.