title: Tuberculous lymphadenitis in Northern Ethiopia: in a public health and microbiological perspectives.
abstract: BACKGROUND
  The actual burden and causative agent of tuberculous lymphadenitis (TBLN) cases is not well known due to lack of strong surveillance system and diagnostic facilities in Ethiopia. This study was conducted to determine the prevalence of TBLN, its causative agent and risk factors for acquiring this infection.
  
  
  METHODS
  A cross-sectional study was conducted from April to May 2012 at four main hospitals and one diagnostic clinic located in northern Ethiopia. Fine needle aspirates (FNAs) from TBLN suspects were taken for acid fast bacilli (AFB) microscopy, culture and molecular typing.
  
  
  RESULTS
  Among 437 aspirates, culture yielded AFB in 226 (51.7%) of cases. Sixty one culture negative cases (30.5% of 200 cases) were positive by Xpert MTB/RIF test. Moreover, a rifampicin resistant AFB was detected from culture negative cases. The overall prevalence of FNAs positive TBLN cases was 65.8 %. The BacT/AlerT 3D system proved to be a more rapid method with higher recovery rate than Lowenstein-Jensen (L-J) and/or Gottsacker media (P<0.0001). Molecular typing identified all culture positive isolates as M.tuberculosis. The main risk factors for TBLN were pediatric age (OR 2.8, 95% CI, 1.09- 7.05) and cough (OR 2, 95%CI, 1.09-3.7).
  
  
  CONCLUSIONS
  The results of this study revealed a high prevalence of TBLN in the study sites and that pediatric age and cough are key predictors of the disease. TBLN is an important public health problem that needs to be addressed in the area. It is important to note that MDR strains of TB could be involved and aetiological confirmation and drug sensitivity testing of TBLN isolates should be expanded. Further studies on the M.tuberculosis lineages, circulating strains and transmission dynamics, are recommended.
authors.affiliation: College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia ; Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital, University of Leipzig, Leipzig, Germany ; Institute of Clinical Immunology, University Hospital, University of Leipzig, Leipzig, Germany ; Translational Centre for Regenerative Medicine (TRM)-Leipzig, University of Leipzig, Leipzig, Germany.
authors.forename: Fantahun
authors.initials: F
authors.lastname: Biadglegne
authors.affiliation: College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Weghata
authors.initials: W
authors.lastname: Tesfaye
authors.affiliation: Institute of Clinical Immunology, University Hospital, University of Leipzig, Leipzig, Germany ; Translational Centre for Regenerative Medicine (TRM)-Leipzig, University of Leipzig, Leipzig, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Sack
authors.affiliation: Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital, University of Leipzig, Leipzig, Germany.
authors.forename: Arne C
authors.initials: AC
authors.lastname: Rodloff
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000473:pathology; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008198:Lymph Nodes / Q000382:microbiology* / Q000473:pathology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000302:isolation & purification*; D015995:Prevalence; D012293:Rifampin / Q000627:therapeutic use; D014388:Tuberculosis, Lymph Node / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D012293:Rifampin