Distribution and Determinants of Tuberculosis, Kingdom of Saudi Arabia, 2005- 2012 Open Access

Almutairi, Fahad (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/8623hz06b?locale=en


Introduction: Tuberculosis (TB) remains a public health threat in KSA with many challenges that limit its prevention and control. And the laboratory plays a key role in an effective TB program. So to understand how to meet these challenges, we calculated the TB incidence rates (IRs) in KSA from 2005 - 2011 and assessed the laboratory capabilities by determining the proportion of laboratory-confirmed TB cases.

Methods: We estimated the TB IRs and 95% confidence interval (CI) stratified by nationality, gender, and administrative regions from 2005 - 2012. We also calculated the proportion of TB cases by age category, employment status, and nationality.

Results: The overall KSA TB IRs showed statistically significant decrease from 15.80 per 100,000 population in 2005 (95%CI=15.29 - 16.31) to 13.16 in 2012 (95%CI=12.74 - 13.58). The IRs for males and females were similar from 2005 - 2008. But from 2009 - 2012, the IRs for males were greater than those of females. And the IRs of non-Saudis were approximately twice those of Saudis during the study period. Mecca region had a consistently greater IR over the study period compared with other regions (25.13 per 100,000 [95%CI=24.7 - 25.56]). Riyadh region had the second highest IR (17.9 cases per 100,000 population [95%CI=17.53 - 18.27] followed by Jazan (17.1 cases per 100,000 population [95%CI=16.31 - 17.89]. Non-Saudis from these countries had the greatest proportion of TB cases: Indonesia (15.4%); Yemen (12.9%); and India (9.7%). Individuals < 15 years of age made up 14.2% of the TB cases, those aged 21-30 made up 27.7% of the cases, and those ≥ 65 composed 7.4% of the cases. By employment status, we observed employed non-Saudis with the greatest proportion of TB (32%), followed by unemployed Saudis (22.38%). The proportion of laboratory-confirmed cases of reported TB was 57% from 2005 - 2012. Medina and the Eastern Region had the greatest proportion of laboratory-confirmed cases of reported TB (64%).

Discussion: There were a decrease in the overall TB IRs over the study period. The IRs were greater among non-Saudis compared to Saudis. Medina and Eastern Region had the greatest proportion of laboratory-confirmed cases of reported TB. We note that for effective prevention and control, TB screening should be implemented for all non-Saudi workers at ports of entry. Plus, laboratory-screening capacity for all reported cases of TB should be evaluated throughout the country and strengthened.

Table of Contents

Chapter One: Introduction. 7

Chapter Tow: Literature Review. 10

Chapter Three: Manuscript. 19

Chapter four: Conclusion. 36

Refrences. 39

Appendix one. 40

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