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Tuberculosis in Rivers state: autopsy and surgical pathology study in the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt (1990-2002).

BACKGROUND
A 13 year (1st January 1990 - 31st December 2002) retrospective study of 138 surgical and autopsy specimens diagnosed as Tuberculosis (Tb) was studied in Port Harcourt, based on the age, sex, affected tissue and the immune status of the patients.


METHOD
The tissues were initially fixed in 10% formal saline, processed and embedded in paraffin wax. The tissue were sectioned, mounted on glass slide and stained with hematoxylin and eosin (H & E). In some cases (12.3%) special stains were used to confirm the bacilli and to exclude parasitic or fungal agents. The immune status and the causes of death were extracted from the request forms, case notes and autopsy reports.


RESULTS
Of the 138 specimens, 37 (26.8%) and 101(73.2%) were obtained from autopsy and surgery respectively. Male to female ratio was 2:1. The youngest was a 3 year old male and the eldest was a 83 year old female. Children below 11 years contributed the highest specimens at autopsy while the highest frequency of surgical specimens were removed from 41-50 years age group (23.8%). The commonest cause of death was pulmonary tuberculosis with respiratory failure. The commonest tissue affected was the lymph node presenting either singly or matted together. Primary tuberculosis accounted for 15.9% (22) of cases while secondary tuberculosis was 116 (84.1%) presenting in different forms. HIV screening was positive in 39 (28.3%) cases.


CONCLUSION
Despite the preventive measures and treatment of tuberculosis, the disease is still on the increase in this environment. The upsurge may be associated with HIV infection and immunodeficiency. It is therefore necessary to screen all tuberculosis patients for possible HIV positivity.