Burden of Tuberculosis in stage 5 chronic kidney disease patients undergoing maintenance haemodialysis therapy in governmental and non-governmental dialysis centers in Addis Ababa, Ethiopia: A cross-sectional study
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Date
2023-11
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Addis Ababa University
Abstract
Background
Patients with End stage renal disease appear to be at a higher risk of TB due to
immunosuppression along with socioeconomic, demographic, and comorbidities. Despite high
burden of Tuberculosis in developing countries, there is a scarcity of data regarding burden of
TB in ESRD in Ethiopia.
Objective
The objective of this study is to assess the burden of TB in End stage renal patients receiving
haemodialysis in Addis Ababa, Ethiopia.
Method
A cross-sectional study was conducted on Burden of Tuberculosis in stage 5 chronic kidney
disease patients undergoing maintenance hemodialysis therapy in governmental and non-
governmental dialysis centers in Addis Ababa, Ethiopia from August 2022 to October 2022
G.C. Patients with a baseline diagnosis of ESRD on HD and age 18 years and above were
included in the study. Patients were recruited during their dialysis visit using convenient
sampling method and consent was obtained from all participants. A total of 263 participants
were included in this study. The diagnosis of ESRD and TB was defined using KDGIO and
WHO guidelines. Data were collected through patients interview and reviewing the patient’s
electronic medical records. The Collected Data was analyzed using SPSS version 26.0.
Results
Our study found a diagnosis of tuberculosis in 71 (27%) of study participants. Among the
study participants who was diagnosed with TB, 64 (24.3%) had a previous diagnosis of TB
and 12 had active TB.Pulmonary tuberculosis was diagnosed in two-third of TB patients and
about third had EPTB, TB lymphadenitis was the commonest followed by pleural TB.
Imaging evidence was used to make a diagnosis of TB in one-third patients followed by
FNAC (26.6%) and Pleural fluid analysis (26.6%). More than half (54.7%) of TB diagnosis
was made after initiation of haemodialysis. More than half (54.7%) of TB diagnosis was made
after initiation of haemodialysis. Having a contact history with a known TB patient, presence
of HIV infection and duration on dialysis for more than 1 year were associated with increased
prevalence of TB among CKD patients.
Conclusions
Because of its atypical presentation and since it is a mimicker of uremic symptoms, physicians
should maintain a high degree of suspicion to consider TB among CKD patients. Early
identification and treatment of TB among CKD patients is important in decreasing morbidity
and mortality among these patients and in decreasing the transmission of TB among patients
who undergo dialysis in the same center. TB preventive therapy should also be considered for
this group of patients
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Keywords
Tuberculosis, End stage renal disease, chronic kidney disease, dialysis, Addis Ababa