Osteoarticular Tuberculosis in South of Tunisia: Eradicated or still Endemic?

Fatma Hammemi^1,4, Houda Ben Ayed^2,4*, Makram Koubaa^1,4*, Maissa Ben Jemaa², Khaoula Rekik, Maroua Trigui², Mariem Ben Hmida², Chokri Masmoudi³, Chakib Marrakchi^1,4, Mohamed Ben Jemaa⁵, Emna Elleuch^1,4, Imed Maaloul^1,4, Sourour Yaich², Jamel Damak¹ & Mounir Ben Jemaa^1,4

¹Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
²Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
³Regional Primary Health Care Directory, Sfax, Tunisia ⁴Extra-pulmonary Research Unity, Hedi Chaker University Hospital, Sfax, Tunisia
⁵Department of Orthopedics

Dr. Houda Ben Ayed & Dr. Makram Koubaa, Extra-pulmonary Research Unity, Hedi Chaker University Hospital, Sfax, Tunisia.

Keywords: Disease Evolution; Epidemiology; Osteoarticular; Tuberculosis; Antitubercular

Abstract

Introduction
Despite preventive measures, tuberculosis (TBC) is still a public health problem worldwide. Osteoarticular tuberculosis (OATBC) requires an early diagnosis and an effective treatment in order to limit complications and sequelae. In our country, recent and exhaustive OATBC data are scare. In this perspective, we aimed to study the epidemiological, clinical and evolutionary features of OATBC.
Methods
We conducted a retrospective study including all patients with TBC in Southern Tunisia between 1995 and 2016.
Results
Totally, we enrolled 181 cases of OATBC. There were 93 females (51.4%). The mean age was 47 ± 20 years old. The main site was spondylodiscitis in 131 cases (72.3%). The mean duration of treatment was 12±5 months. The disease evolution was favourable in 143 cases (80%). In comparison with other forms of extra pulmonary TBC, patients aged 60 years and above were significantly more affected by OATBC (Odds ratio (OR) = 2.4; p < 0 xss=removed xss=removed xss=removed xss=removed> Conclusion
OATBC was ranked at an alarming rate in our region. Despite an adequate treatment, the prognosis was more severe in comparison with other extra pulmonary tuberculosis sites, particularly among elderly. An early diagnosis and a regular follow-up are highly recommended in order to avoid severe forms and sequelae.

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