The patterns and distribution of female genital tuberculosis among Togolese patients

Pan Afr Med J. 2022 Oct 7:43:62. doi: 10.11604/pamj.2022.43.62.32965. eCollection 2022.

Abstract

Tuberculosis is a real public health problem in developing countries. The aim of our article was to study the epidemiological, clinical, diagnostic characteristics of female genital tuberculosis in Togo. This was a descriptive and cross-sectional study on all cases concerning histologically diagnosed female genital tuberculosis in the department of pathological anatomy of Lomé in 1997-2018 (20 years). We collected 22 cases of women's Genital tuberculosis (GT), representing 2.2% (1008 cases) of extra-pulmonary tuberculosis. The mean age of the patients was 33.8 ± 0.2 years. Nine (9) patients had a history of treated GT. Depending on the location, the ovaries and fallopian tubes were the most affected (n=9 cases, 40.9%). Eighteen patients (81.8%) had at least one immunosuppression factor including HIV in 13 patients (72.2%). The reasons for consultation were metrorrhagia and pelvic pain with an associated mass in 7 women discovered on clinical examination and imaging. The macroscopic appearance of the specimens was suggestive of the diagnosis of genital tuberculosis in 12 cases (54.5%). Histology revealed caseous necrosis isolated in 3 patients (13.6%) and associated with gigantocellular epithelioid granulomas in 19 patients (86.4%). The patients received standard antibiotic treatment combining rifampicin, isoniazid, ethambutol and pyrazinamide. Genital tuberculosis is a rare extra-pulmonary location in Togo, often occurring in women with HIV, and the clinical polymorphism can lead to confusion with gynecological cancers.

Keywords: Female GT; Intertropical Africa; Togo; bleeding; caseous necrosis; inflammatory granuloma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Ethambutol / therapeutic use
  • Female
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Humans
  • Tuberculosis* / complications
  • Tuberculosis, Female Genital* / complications
  • Tuberculosis, Female Genital* / diagnosis
  • Tuberculosis, Female Genital* / epidemiology

Substances

  • Ethambutol