Abstract
OBJECTIVES: To determine the magnitude and factors associated with extrapulmonary tuberculosis (EPTB) and examine differences in clinicodemographic features compared to presumptive EPTB. METHODS: A cross-sectional study was conducted between August 2022 and October 2023 to enroll 542 participants from eleven public hospitals. Microbiologic confirmations of EPTB were made using Xpert MTB/RIF-Ultra and TB culture. Clinicodemographic variables were described using frequency and compared using chi-square and regression statistics. RESULT: The prevalence of culture-confirmed EPTB was 34.9% (95% confidence interval [CI]: 30.9-39.0). The mean platelet count distribution was higher among microbiologically confirmed EPTB (P <0.001), whereas leukocytosis and erythrocytopenia were significantly associated with presumptive EPTB (P <0.001), without differences in the mean hemoglobin concentration (P >0.05). However, the area under the curve (AUC) of hematological indices poorly distinguished presumptive and confirmed EPTB (AUC = 0.533-0.645). Previous TB treatment history (adjusted odds ratio [AOR] = 3.7, 95% CI: 1.9-6.9) and HIV coinfection (AOR = 3.1, 95% CI: 1.3-7.3) were predictors of microbiologically confirmed EPTB. Alcohol use (AOR = 1.7, 95% CI: 1.1-2.6), hospitalization (AOR = 2.5, 95% CI: 1.6-3.8), and any treatment nonadherence history (AOR = 1.9, 95% CI: 1.2-2.9) were significantly associated with presumptive EPTB. CONCLUSIONS: The prevalence of EPTB in Ethiopia remains high. Most clinical features of presumptive and confirmed EPTB overlap, while there are slight differences in sociodemographic characteristics.