Dynamic Challenges of Active Tuberculosis: Prevalence and Risk Factors of Co-Infection in Clinical and Microbiological Characteristics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Abstract

Background: Tuberculosis (TB) is a major public health issue in Saudi Arabia, particularly impacting the elderly. Immunocompromising conditions, including comorbidities, malignancies, and the use of immunosuppressive agents, are major risk factors for active TB (ATB).

Objective: To analyze clinical factors and estimate mortality in TB and drug-resistant cases.

Methods: This retrospective study analyzed medical records of 12,494 patients at KAUH (2019-2021), identifying 131 confirmed TB cases with comprehensive data on demographics, clinical features, comorbidities, diagnostics, and outcomes. Data were analyzed using SPSS, with chi-square and logistic regression identifying risk factors. Statistical significance was determined at a threshold of p < 0.05. In our study, logistic regression was employed to identify significant predictors of mortality among TB patients. The results were presented using beta coefficients (B) to quantify the relationship between predictors and the outcome, along with the adjusted odds ratio (AOR) to provide an interpretable measure of the strength of these associations.

Results: Of the 131 TB patients involved in this paper, a higher incidence of pulmonary TB was observed among men under 30 years old. This group also showed a higher mortality rate due to comorbidities such as renal failure, human immunodeficiency virus (HIV), and autoimmune disease. The risk of mortality was heightened by 69.47% with drug susceptibility. Additionally, 19.85% of the patients had multidrug-resistant TB (MDR-TB), and 10.69% had extensively drug-resistant TB (XDR-TB). Patients undergoing hemodialysis, and those with respiratory comorbidities, cancer, diabetes, and smoking were found to have a higher mortality hazard, indicating these as significant risk factors for TB.

Conclusion: This study highlights TB's prevalence and drug resistance at KAUH, emphasizing high-risk groups, including males and young adults. Effective strategies, targeted interventions, and future research are vital for reducing mortality.