Epidemiology of Extrapulmonary TB and its risk factors in Damascus, Syria.

Background: Tuberculosis (TB) is a major public health concern worldwide and is the 13th leading cause of death, and the second deadliest infectious disease after COVID-19 worldwide 1 . Extrapulmonary tuberculosis (EPTB) cases accounted for 15% of the 7.2 million cases of TB worldwide in 2019. ² global statistics indicate that Tuberculosis causes 4,500 deaths every day¹. We aim to study the epidemiology of EPTB and its risk factors. Methods: A multicenter retrospective study was conducted at the National Center for Tuberculosis Control in Damascus in the year 2020 to analyze the patients with extrapulmonary tuberculosis. Results: 205 patients were diagnosed with extrapulmonary tuberculosis in Damascus and its countryside in the year 2020, and the most common site of extrapulmonary tuberculosis was Lymph Nodes (102) 49.75%, while ear and breast were the least common (1 case of each). Cervical nodes were the most affected with EPTB (80.40%), while Mediastinal nodes were the least affected (1.96%). The most incidence rate was in patients between 25 and 34 years old, while the least incidence rate was in patients older than 65 years old. The percentage of infected females was approximately 66%, while the percentage of infected males was approximately 34%. The majority of infected patients were residents in the city (78.68%) compared to infected patients from the countryside (21.31%). The most common comorbidity was Hypertension: 23.41% of cases, while kidney diseases were the least common. Smoking was the most common risk factor. The most common general symptom associated with extrapulmonary tuberculosis was fever 55.60%, while night sweats were the least common symptom 14.63%. Conclusion: Tuberculosis is a major public health concern worldwide that can cause death or cause long-lasting complications but still can be prevented by vaccination and avoiding the possible risk factors that were studied in this study.