Prevalence and presentation of tuberculosis in esrd in port sudan

Tuberculosis is the commonest infectious communicable disease in Red sea state- Sudan, in the last years the percentage of extrapulmonary tuberculosis exceeding that of pulmonary tuberculosis, multiple factors may contribute in this and these factors must be investigated. At same time incidence of renal failure also increased in the last years in Red sea state.
Several factors contributed in transmission of tuberculosis, and renal failure is one of these factors, as it affect the immunity, reducing body mass and responsible for reduction of vitamin D. In addition over crowd in dialysis centre and contamination of dialysis sets represent other factors making those on dialysis at higher risk to develop tuberculosis. At same time tuberculosis may be a cause of CKD secondary to genitourinary tuberculosis or through haematological spread from latent or active pulmonary tuberculous lesion. Both tuberculosis and renal failure worsening morbidity of each other.
Diagnosis of tuberculosis in those of ESRD is more difficult than in normal population as symptoms of ureamia mimicking general symptoms of tuberculosis. Pulmonary tuberculosis in those patient has atypical radiological presentation, Mantoux test usually negative, Z- N stain usually negative, and TB usually presented as EPTB, so This is a prospective, descriptive, and interventional study done in Port Sudan dialysis centre in 246 patients of ESRD on haemodialysis to know the prevalence and pattern of tuberculosis among patient of ESRD in Red sea state and to find out criteria for early detection of tuberculosis in ESRD. In this study M: F is 2:1 mean age is 47 years, Bija tribe 75%, non Bija 25%.. The commonest cause of ESRD was hypertension followed by diabetes. Prevalence of TB among ESRD in Port Sudan is 11.4% presented as post primary 21.4%, latent TB 18%, tuberculous pleural effusion 21.4%, tuberculous peritonitis 21.4%, tuberculous pericarditis 10.7% and tuberculous lymphadenitis 7.1%. Risk factors for tuberculosis among those patient were over crowd in dialysis centre, poor ventliation of the centre, lag of infection control measurement, poor neutritional state and diabetes.