Prevalencia de tuberculosis extrapulmonar en pacientes que acuden al Centro de Salud Pascuales durante el periodo 2017 – 2020.

Abstract

In Ecuador, according to the last report published in 2018, extrapulmonary tuberculosis corresponds to 18.46% of the cases of sensitive tuberculosis, so we set out to determine the prevalence of the different types of extrapulmonary tuberculosis within a first level of care health facility and to characterize the risk factors, comorbidities and other characteristics. Methodology: A descriptive, observational and retrospective study of patients with extrapulmonary tuberculosis attended at the Pascuales Health Center during the period 2017- 2021 was conducted. Database collection was obtained by reviewing physical medical records. Results: The prevalence of tuberculosis during 2017 was 58 (22%) patients diagnosed with pulmonary TB and 14 (22%) with extrapulmonary TB. In 2018, cases diagnosed with pulmonary TB were 53 (20%) and extrapulmonary type 20 (31%). During 2019, 80 (31%), patients were pulmonary cases and 16 (25%) extrapulmonary. During the last period, 69 (27%) cases were pulmonary and 14 (22%) extrapulmonary patients. The prevalence of the different sites of tuberculosis involvement is; intestinal TB, which occurs in 18 patients (28%), pleural TB in 14 cases (21%). With 10 (16%) cases there is lymph node TB. After that, meningeal TB continued with 11% in 7 patients, followed by bone TB in 6 cases (9%), miliary TB in 5 cases (8%), renal TB in 2 cases (3%), interstitial TB in 2% and mammary gland TB (2%). Within the study, 94% (60) patients were new patients and 6% (4) of the cases were relapses. According to age, 28 (44%) of the patients diagnosed with extrapulmonary TB were between 31 and 45 years of age, followed by 16 (25%) patients between 46-70 years, then 14 (22%) between 17- 30 years and 6 (9%) patients between 0-16 years. According to gender, 54 (84%) cases belonged to the male category and 10 (16%) to the female category. The comorbidities attributed are HIV in 33 of the patients with a (52%), followed by arterial hypertension with 12% i.e. 8 patients, diabetes mellitus in about 4 patients (6%) and chronic liver disease in 1 case (2%), however, there are also 18 cases representing 28% in which no comorbidity added to the diagnosis is evidenced. Conclusions: It is concluded that the prevalence of extrapulmonary tuberculosis in Pascuales Health Center during the period 2017-2020 was 0.077%. The majority of cases occurred in 2018 at 31%. The most frequent types of tuberculosis are intestinal tuberculosis with 28% (18) cases, followed by pleural tuberculosis with 21% (14) cases and lymph node tuberculosis in 16% (10) patients. With respect to the types of patients, only 6% (4) patients relapsed, that is to say that the treatment applied was successful in most of the patients. In relation to age, the largest group of cases is 28 (44%) patients diagnosed with extrapulmonary TB who are between 31 and 45 years of age. According to gender, 54 (84%) cases belonged to the male category. The comorbidity most commonly attributed to these patients is HIV in 33 patients (52%). It is recommended that greater emphasis be given to the different types of tuberculosis, establishing greater awareness of the risk factors, comorbidities, clinical presentation, diagnostic tools and timely treatment, especially in primary health care facilities that provide monitoring and follow-up of this disease.