Tuberculous lymphadenitis in South-Eastern Nigeria; A 15 years histopathologic review (2000-2014)

• Published in: Annals of medical and health sciences research Vol. 6; no. 1; pp. 44 - 49
• Main Authors: Ukekwe, F, Olusina, D, Banjo, AAF, Akinde, O, Nzegwu, M, Okafor, O, Ocheni, S
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow Publications 01-01-2016; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd
• Subjects: HIV patients; Infection control; Lymph node tuberculosis; Original; Physiological aspects; Statistics; Nigeria; Ziehl-Neelsen; Histology; Tuberculosis; Lymphadenitis; Human immunodeficiency virus/acquired immune deficiency syndrome
• ISSN: 2141-9248; 2277-9205
• DOI: 10.4103/2141-9248.180273

Background: The human immunodeficiency virus (HIV) pandemic has brought about a resurgence in tuberculosis (TB), especially in developing countries. Previous studies on TB lymphadenitis (TBLN) in South-Eastern Nigeria were done before the advent of the HIV pandemic making a review pertinent. Aim: To evaluate the role of TBLN as a cause of superficial lymphadenopathy in the post-HIV/acquired immune deficiency syndrome (AIDS) era of South-Eastern Nigeria. Materials and Methods: This is a 15 years (2000-2014) retrospective review of all superficial lymph node biopsies (SLNBs) received at the Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, Nigeria. Results: One hundred and seventy-two cases of TBLN were identified in this study constituting 14.6% (172/1,180) of SLNBs received at our Hospital′s Morbid Anatomy Department during the 15 years period under review. Twenty-eight cases of TBLN were clinically screened for HIV, 23 of which tested positive, representing 82.1% (23/28) of clinically screened cases. Acid fast bacilli demonstration was positive in 15.1% (26/172) of cases using Ziehl-Neelsen stain. 48.8% (84/172) of TBLN cases were males, and 51.2% (88/172) were females with most (22) cases received in 2012 and least (5) cases in 2000. Most TBLN occurred in the 21-25 years age group with a total of 21.5% (37/172) of cases and a male to female ratio of 1:1.5 The most common biopsy site for TBLN was the cervical group followed by the axillary and inguinal groups with 73.8% (127/172), 14% (24/172), and 4.7% (8/172) of cases, respectively. Conclusions: There is a remarkable decline in the prevalence of TB lymphadenitis in South-Eastern Nigeria indicating a change in trend from the pre- to the post-HIV/AIDS era with slightly more females now presenting with TBLN and most TB lymphadenitis patients now presenting with associated HIV/AIDS disease. There is an urgent need to provide modern diagnostic facilities in our medical laboratories.