Trends and characteristics of patients admitted with musculoskeletal tuberculosis to a referral hospital from 2003 – 2008

Abstract

Tuberculosis (TB) remains the most common cause of death from infectious disease world-wide. Extrapulmonary diagnosis remains challenging especially in developing countries such as Botswana. The increasing global burden of tuberculosis is linked to HIV-infection and sub-Saharan Africa is the hardest hit by tuberculosis epidemics due to the high incidence and prevalence of HIV-infection. This study evaluated the prevalence and trends of musculoskeletal tuberculosis in Nyangabgwe Referral Hospital in the Northern part of Botswana. A descriptive retrospective study was performed whereby all patients admitted with musculoskeletal TB to the Nyangabgwe Referral Hospital, Botswana between 1st January, 2003 and the 31st December, 2008 were reviewed. A total of 744 TB cases were reported between 2003 and 2008. A review of the reports showed that 53 cases were diagnosed with mTB. Seventy-seven percent of the patient files reviewed showed a decline in the prevalence of mTB cases from 10.3% in 2003 to 3.9% in 2008. Prevalence of HIV-infection among the TB cases was 39%, and 81% of these had CD4 + T-cell counts of less than 200cells/ul. This decline in mTB prevalence may be related to an increased provision of isoniazid preventive therapy (IPT) and highly active antiretroviral therapy (HAART) in Botswana over the past 5 years.