Risk Factors for Extrapulmonary Tuberculosis in Bangladesh: A Country with High Tuberculosis Prevalence

Abstract

Tuberculosis (TB) is a major public health problem in Bangladesh. In this case-control retrospective study, a total of 348 patients, either with pulmonary TB (PTB) or extrapulmonary TB (EPTB), were surveyed from April 2020 to January 2023 from five different districts of Bangladesh to identify risk factors of EPTB. The results revealed that most of the surveyed TB patients were infected with PTB (225 patients) while 123 patients were infected with EPTB. Males were more susceptible to PTB while females were more prone to EPTB. EPTB was more prevalent in younger people than older people as compared with PTB. Likewise, married patients were more prone to PTB than EPTB while unmarried patients were equally susceptible to both PTB and EPTB. Brain, lymph node and intestine were major organs which were infected by EPTB, but the prevalence of EPTB of intestine, lymph node and breast were higher for female than for male. BCG vaccination showed more preventive role against EPTB than PTB. EPTB was prevalent in certain blood groups and occupations. Similarly, the people with very dark brown skin and underweight in childhood were more prone to EPTB. The data also revealed that family members with EPTB, regular medication, less exposure to direct sunlight, and mental stress increased the prevalence of EPTB. Contrary, addiction to smoking, average sleeping hours, and use of mosquito coil were dispensable factors affecting the prevalence of EPTB. All these findings emphasize the necessity for addressing specific risk factors, to decrease the burden of EPTB in Bangladesh.