title: Prevalence and presentation of tuberculosis among hemodialysis patients in Khartoum, Sudan.
abstract: Tuberculosis (TB) is a major health problem in the developing countries. There are limited data about the prevalence of TB patients on maintenance hemodialysis (HD) in Sudan. The aim of this study is to identify the prevalence and presentation of TB among Sudanese maintenance HD patients. This is a hospital-based descriptive study. The participants of the study are all HD patients distributed in 13 HD centers in Khartoum and Khartoum North Provinces in Sudan. All patients attended the HD centers from November 1, 2014 to February 1, 2015, were interviewed by a questionnaire focused on personal and clinical data. Those who were diagnosed as having active TB were studied regarding their clinical presentation, presence of comorbidities, site of TB, and methods used on diagnosis. The total number of HD patients during the study period was 1328 patients. We found 19 patients who already diagnosed and treated for TB infection. The prevalence rate of TB among HD patients is 1.4%. The mean age of patient was 44.53±8.69 years, 89.5% of them were males. The majority of them have comorbidities: 31.6%% have hypertension and 21.1% have diabetes. Extrapulmonary TB was the major presentation (57.9%) mainly tuberculous lymphadenitis (26.3%). The pulmonary presentation was found to be 42.1%. The diagnosis of TB was supported by microbiological evidence of alcohol acid-fast Bacilli present in sputum smear (21%), histological diagnosis (31.6%), polymerase chain reaction (21%), and imaging in (26.3%). Patients on maintenance HD are at an increased risk of TB and diagnosis of TB among HD patients need a high index of suspicion. There is a great need for establishing a screening scheme for TB among HD patients and further epidemiological studies are needed to fully evaluate this problem.
authors.affiliation: Department of Medicine and Nephrology, University of Medical Sciences and Technology; Department of Hemodialysis, Academy Charity Teaching Hospital, Khartoum, Sudan.
authors.forename: Amin S I
authors.initials: AS
authors.lastname: Banaga
authors.affiliation: Department of Nephrology, Academy Charity Teaching Hospital, Khartoum, Sudan.
authors.forename: Nihad K
authors.initials: NK
authors.lastname: Siddiq
authors.affiliation: Department of Nephrology, Academy Charity Teaching Hospital, Khartoum, Sudan.
authors.forename: Randa T
authors.initials: RT
authors.lastname: Alsayed
authors.affiliation: Department of Basic Sciences, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan.
authors.forename: Rasha
authors.initials: R
authors.lastname: Babiker
authors.affiliation: Department of Public Health, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: Khalifa
authors.initials: K
authors.lastname: Elmusharaf
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D006435:Renal Dialysis; D013183:Sputum; D013397:Sudan / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*