Volume 29, Issue 2 (5-2026)
J Arak Uni Med Sci 2026, 29(2): 157-164 |
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Soltani M, Mazaherpour H, Safari M, Sofian M. Trends and Specific Characteristics of Patients with Pulmonary and Extrapulmonary Tuberculosis in Arak, 2016–2023: A Retrospective Cross-sectional Study. J Arak Uni Med Sci 2026; 29 (2) :157-164
URL: http://jams.arakmu.ac.ir/article-1-8153-en.html
URL: http://jams.arakmu.ac.ir/article-1-8153-en.html
1- Student Research Committee, Arak University of Medical Sciences, Arak, Iran
2- Assistant Professor, Infectious Diseases Research Center (IDRC), Arak University of Medical Sciences, Arak, Iran
3- Assistant Professor, Department of Biostatistics, School of Medicine, Clinical Research Development Unit of Amiralmomenin Hospital, , Arak University of Medical Sciences, Arak, Iran
4- Associate Professor, Infectious Diseases Research Center (IDRC), Arak University of Medical Sciences, Arak, Iran ,ma_sofiyan@yahoo.com
2- Assistant Professor, Infectious Diseases Research Center (IDRC), Arak University of Medical Sciences, Arak, Iran
3- Assistant Professor, Department of Biostatistics, School of Medicine, Clinical Research Development Unit of Amiralmomenin Hospital, , Arak University of Medical Sciences, Arak, Iran
4- Associate Professor, Infectious Diseases Research Center (IDRC), Arak University of Medical Sciences, Arak, Iran ,
Abstract: (418 Views)
Background: Tuberculosis (TB) is one of the most important infectious diseases worldwide, presenting in pulmonary (PTB) and extrapulmonary (EPTB) forms. Evaluating its trends and characteristics in each region plays a crucial role in prevention and control programs. The present study aimed to investigate trends in prevalence and compare certain characteristics of patients with PTB and EPTB in Arak, Markazi Province, Iran, from 2016 to 2023.
Methods: In this retrospective cross-sectional study, all 359 patients with confirmed TB recorded at the Arak Health Center were investigated using a census sampling method. Data were analyzed using appropriate statistical tests in SPSS software, version 26.
Results: Among 359 patients, 282 (78.6%) had PTB and 77 (21.4%) had EPTB. The annual prevalence of PTB and EPTB decreased by 6% and 8.7%, respectively (P<0.001). PTB patients were older (66.25 vs. 52.80 years, P<0.001). EPTB was more frequent among urban residents (92.2%) and those with higher BMI (24.02 vs. 21.08, P<0.001). Diagnostic delay was longer in EPTB (78.83 vs. 34.78 days, P<0.001), while hospitalization was significantly higher in PTB (P=0.015).
Conclusion: The trend of TB prevalence in Arak has declined in recent years. However, diagnostic delays and differences in the characteristics of PTB and EPTB cases highlight the need for targeted measures in the referral system to improve disease control.
References
1. World Health Organization. Global Tuberculosis Report. 2024. Available from: https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2025
2. Bloom BR. A half-century of research on tuberculosis: Successes and challenges. J Exp Med. 2023;220(9):e20230859. pmid: 37552470 doi: 10.1084/jem.20230859.
3. Kyagulanyi E, Mirembe J, Nantaayi B, Nalukenge S, Mukasa D, Tamale J, et al. The prevalence of concurrent pulmonary and extrapulmonary tuberculosis in Uganda: a retrospective study. Ther Adv Infect Dis. 2022;9:20499361221107304. pmid: 35795170 doi: 10.1177/20499361221107304
4. Ayed HB, Koubaa M, Marrakchi C, Rekik K, Hammami F, et al. Extrapulmonary Tuberculosis: Update on the Epidemiology, Risk Factors and Prevention Strategies. Int J Trop Dis. 2018;1:006. Doi:10.23937/ijtd-2017/1710006.
5. Sharma SK, Mohan A, Kohli M. Extrapulmonary tuberculosis. Expert Rev Respir Med. 2021;15(7):931–48. pmid: 33966561 doi: 10.1080/17476348.2021.1927718
6. Hershkovitz I, Donoghue HD, Minnikin DE, May H, Lee OYC, Feldman M, et al. Tuberculosis origin: The Neolithic scenario. Tuberculosis (Edinb). 2015;95(Suppl 1):S122–6. pmid: 25726364 doi: 10.1016/j.tube.2015.02.021
7. World Health Organization. Global Tuberculosis Report 2022. 2022 Oct 27 [cited 2025 Oct 26]. Available from: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022%
8. Doosti A, Nasehi M, Moradi G, Roshani D, Sharafi S, Ghaderi E. The pattern of tuberculosis in Iran: a national cross-sectional study. Iran J Public Health. 2023;52(1):193–200. pmid: 36824245 doi: 10.18502/ijph.v52i1.11682
9. Fallah S, Nasehi M, Etemadinezhad S, Fallah S, Charati JY, Charati Y. A five-year epidemiological study of extra-pulmonary tuberculosis and its related risk factors in Iran. Tanaffos. 2022;21(2):221. pmid: 36879733
10. Farazi AA, Sofian M, Jabari Asl M. Extra-Pulmonary Tuberculosis and Its Comparison with Pulmonary Tuberculosis in Central Province (2002-2012) [in Persian]. J Arak Univ Med Sci. 2013;16(5):58–66.
11. Hashemzadeh M, Dezfuli AAZ, Khosravi NA, Mehr FJ. A retrospective study of extrapulmonary tuberculosis in the Khuzestan province of southwest Iran between 2002 and 2023. BMC Infect Dis. 2024;24(1):1463. pmid: 39722034 doi: 10.1186/s12879-024-10386-0
12. Alavi SM, Enayatrad M, Cheraghian B, Amoori N. Incidence trend analysis of tuberculosis in Khuzestan Province, southwest of Iran: 2010–2019. Glob Epidemiol. 2023;6:100118. pmid: 37637715 doi: 10.1016/j.gloepi.2023.100118
13. Fallahi MJ, Nazemi M, Zeighami A, Shahriarirad R. Changes in incidence and clinical features of tuberculosis with regard to the COVID-19 outbreak in Southern Iran. BMC Infect Dis. 2024;24(1):1043. pmid: 39333984 doi: 10.1186/s12879-024-09947-0
14. Migliori GB, Thong PM, Akkerman O, Alffenaar JW, Álvarez-Navascués F, Assao-Neino MM, et al. Worldwide effects of coronavirus disease pandemic on tuberculosis services, January–April 2020. Emerg Infect Dis. 2020;26(11):2709–12. pmid: 32917293 doi: 10.3201/eid2611.203163
15. Tavakoli A. Incidence and prevalence of tuberculosis in Iran and neighboring countries. Zahedan J Res Med Sci. 2017;19(7):e9238. Doi:10.5812/zjrms.9238
16. Ahmadi F, Mohammadi MJ, Helalinasab A, Salmanzadeh S. Epidemiologic survey of extra-pulmonary tuberculosis in Ahvaz from 2008 to 2013. Clin Epidemiol Glob Health. 2020;8(3):802–5. doi:10.1016/j.cegh.2020.02.003
17. Wang W, Guo W, Cai J, Guo W, Liu R, Liu X, et al. Epidemiological characteristics of tuberculosis and effects of meteorological factors and air pollutants on tuberculosis in Shijiazhuang, China: A distribution lag non-linear analysis. Environ Res. 2021;195:110310. doi:10.1016/j.envres.2020.110310
18. Moyo S, Oladimeji O, Chikovore J, Zungu N. Tuberculosis and the Relevance of Sex- and Gender-Based Analysis. In: Sex- and Gender-Based Analysis in Public Health. Cham: Springer International Publishing; 2021. p. 85–97.
19. Alavi-Nain R, Mood BS, Metanat M. The gender differences in tuberculosis in a highly endemic region of Iran. J Med Sci. 2007;7(7):1218–20. doi: 10.3923/jms.2007.1218.1220
20. Sreeramareddy CT, Panduru K V, Verma SC, Joshi HS, Bates MN. Comparison of pulmonary and extrapulmonary tuberculosis in Nepal- a hospital-based retrospective study. BMC Infect Dis. 2008;8(1):8. PMID: 18218115 doi: 10.1186/1471-2334-8-8
21. Pourostadi M, Rashedi J, Mahdavi Poor B, Samadi Kafil H, Kazemi A, Asgharzadeh M. Tuberculosis Control and Role of Molecular Epidemiology Studies in Iran: A Systematic Review. Tanaffos. 2017;16(3):190–200. pmid: 29849672
22. Noykhovich E, Mookherji S, Roess A. The risk of tuberculosis among populations living in slum settings: a systematic review and meta-analysis. J Urban Health. 2019;96(2):262–75. pmid: 30341562 doi: 10.1007/s11524-018-0319-6
23. Ibironke O, Carranza C, Sarkar S, Torres M, Choi HT, Nwoko J, et al. Urban air pollution particulates suppress human T-Cell responses to mycobacterium tuberculosis. Int J Environ Res Public Health. 2019;16(21):4112. pmid: 31731429 doi: 10.3390/ijerph16214112
24. Shivakoti R, Sharma D, Mamoon G, Pham K. Association of HIV infection with extrapulmonary tuberculosis: a systematic review. Infection. 2017;45(1):11–21. pmid: 27830524 doi: 10.1007/s15010-016-0960-5
25. Pourakbari B, Mamishi S, Banar M, Keshtkar AA, Mahmoudi S. Prevalence of TB/ HIV co-infection in Iran: a systematic review and meta-analysis. Ann Ig. 2019;31(4):333–48. pmid: 31268118 doi: 10.7416/ai.2019.2295.
26. Jeong YJ, Kang JY, Kim HW, Min J, Ko Y, Oh JY, et al. Association of Underlying Comorbidities and Sites of tuberculosis: an analysis using surveillance data. BMC Pulm Med. 2022;22(1):417. pmid: 36371212 doi: 10.1186/s12890-022-02224-3
27. Norbis L, Alagna R, Tortoli E, Codecasa LR, Migliori GB, Cirillo DM. Challenges and perspectives in the diagnosis of extrapulmonary tuberculosis. Expert Rev Anti Infect Ther. 2014;12(5):633–47. pmid: 24717112 doi: 10.1586/14787210.2014.899900
28. Lee MK, Moon C, Lee MJ, Kwak YG, Lee E, Jeon JH, et al. Risk factors for the delayed diagnosis of extrapulmonary TB. Int J Tuberc Lung Dis. 2021;25(3):191–8. pmid: 33688807 doi: 10.5588/ijtld.20.0788
29. Banta JE, Ani C, Bvute KM, Lloren JIC, Darnell TA. Pulmonary vs. extra-pulmonary tuberculosis hospitalizations in the US [1998–2014]. J Infect Public Health. 2020;13(1):131–9. pmid: 31422038 doi: 10.1016/j.jiph.2019.07.001
30. Wilmink J, Vollenberg R, Olaru ID, Fischer J, Trebicka J, Tepasse PR. Diagnostic Challenges in Extrapulmonary Tuberculosis: A Single-Center Experience in a High-Resource Setting at a German Tertiary Care Center. Infect Dis Rep. 2025;17(3):39. pmid: 40407641 doi: 10.3390/idr17030039
31. Nicholson TJ, Hoddinott G, Seddon JA, Claassens MM, van der Zalm MM, Lopez E, et al. A systematic review of risk factors for mortality among tuberculosis patients in South Africa. Syst Rev. 2023;12(1):23. pmid: 36814335 doi: 10.1186/s13643-023-02175-8
32. Shirzad-Aski H, Hamidi N, Sohrabi A, Abbasi A, Golsha R, Movahedi J. Incidence, risk factors and clinical characteristics of extra-pulmonary tuberculosis patients: a ten-year study in the North of Iran. Trop Med Int Health. 2020;25(9):1131–9. pmid: 32501638 doi: 10.1111/tmi.13452
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