Active Tuberculous Infection among Adult Sudanese Patients on Long Term Peritoneal Dialysis
Active Tuberculous Infection among Adult Sudanese Patients on Long Term Peritoneal Dialysis
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Date
2012-09
Authors
Hasan Abu-Aisha
Mazin Shigidi
Nazik Farouk
Ramy Ibrahim Abulikailik
Rabab Tag Alsir
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Abstract
Introduction: The prevalence of tuberculosis in Sudan is
209 cases per 100,000 populations. There are no reports
available regarding the prevalence of tuberculosis among
the end-stage kidney disease and dialysis populations.
Methods: We reviewed the medical records of all
adults who were on peritoneal dialysis (PD) in the
Sudan Peritoneal Dialysis Program, during the period
from June 2005 to December 2011. Those diagnosed as
having active tuberculous infections were retrospectively
studied regarding their demography, clinical presentation
and outcomes.
Results: Out of 350 patients in our program, 19 were
diagnosed as having active tuberculosis (5.4%). All
patients were diagnosed during their first year on
peritoneal dialysis, 74% were males; the mean age was
37 ± 11 years, extrapulmonary tuberculosis was seen in
16/19 (84%) patients and it was abdominal in nine of the
16 (47%) patients. In addition to high clinical suspicion,
the diagnosis of active tuberculosis was supported by
tissue biopsy findings in 16%, positive polymerase
chain reaction in 26%, exudative ascites with suggestive
radiological features in 21%, strongly positive tuberculin
test in 21% and a favourable response to empirical
antituberculous therapy in 26% of patients. HIV test was
negative in all 19 patients and only one patient tested
positive for hepatitis B viral infection. Antituberculous
drugs side effects were seen in 68% of patients. Forty
seven percent of patients showed complete recovery and
continued on peritoneal dialysis. Our case fatality was
32%.
Conclusion: Abdominal tuberculosis is common among
PD patients and its diagnosis should always be considered
in suspected patients.
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Shigidi, M., Farouk, N., Abulikailik, R.I., Alsir, R.T. and Abu-Aisha, H., 2012. Active tuberculous infection among adult Sudanese patients on long term peritoneal dialysis. Arab journal of nephrology and transplantation, 5(3), pp.135-140.