Abebe et al. BMC Public Health 2012, 12:504 http://www.biomedcentral.com/1471-2458/12/504 TB suspects in the community and link them to health facilities. A contact history with a chronic cougher was highly related with the odds of having TB lymphadenitis. This partly indicates that there is transmission going on in the community although further study may be needed to unravel the transmission dynamics. Moreover, this might indicate that the route of acquisition of lymph node TB is probably the same as pulmonary and can partly ex- plain why Mycobacterium bovis was not detected. Other studies have reported a predominance of Mycobacterium tuberculosis in TB lymphadenitis in Ethiopia [15,16] al- though bovine transmission would be expected where raw milk is consumed. Cervical lymph nodes were the prominent sites involved in our study supporting previous reports [17– 19]. Studies have reported that women were more likely to be positive for TB lymphadenitis compared with men [20–25]. Moreover, it has been suggested that in male dominated communities, where women experience poorer living conditions, young females generally notice differences in their appearance earlier than males [26]. In our study, however, the rate of TB lymphadenitis was not significantly different between the two sexes. Our previous finding from the study area on health seeking behavior also did not find a difference in gender [27]. The age group 35–44 years and FNA samples from axil- lary lymph nodes has shown the largest proportion of cases but difference in prevalence in terms of age group and location of the lymphnodes was not statistically significant. Previous studies have suggested that the extrapulmon- ary forms of TB could be attributed to HIV co infection [18,28]. In Ethiopia the HIV prevalence for rural areas was estimated to be 0.9% [29]. However, in our case all the TB suspects were HIV negative. This suggests that apart from HIV either mycobacterial strains or host fac- tors may play an important role in TB lymphadenitis in this community. Recent reports elsewhere identified that single nucleotide polymorphisms rs4893980 on gene PDE11A of chromosome number 2, rs10488286 on gene KCND2 of chromosome number 7 and rs2026414 on gene PCDH15 of chromosome number 10 in humans were associated with extrapulmonary tuberculosis [30]. In this study we did not do the typing for host genetic factors predisposing for TB lymphadenitis. The strength of our study was that it has tried to ad- dress the neglected component of TB at community level. However, our study was not without pitfalls. We probably underestimated the prevalence of tuberculous lymphadenopathies because individuals were not system- atically examined for lymphadenopathies and culturing of the samples were delayed due to transport problems. Moreover, the methods that we used for the laboratory Page 6 of 7 diagnosis of lymph node TB are not the most sensitive and specific. We did not use PCR which may have high sensitivity in detection of lymph node TB [31]. These all limitations in combination may have resulted in under estimation of the lymph node TB prevalence in commu- nities living in Gilgel Gibe research site. Conclusions The prevalence of TB lymphadenitis was 58 per 100,000 people in Gilgel Gibe. Screening of TB lymphadenitis particularly for family members who have contact with chronic coughers is recommended. Health extension workers could be trained to screen and refer TB lymph- adenitis suspects using simple methods. Competing interest The authors declared that there is no competing interest. Acknowledgments The authors appreciate the study participants for their cooperation in providing the necessary samples and information. The study was funded by the Directorate General for Development Cooperation (DGDC) through the Flemish Interuniversity Council (VLIR-UOS). Author details 1Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia. 2Department of Epidemiology, Jimma University, Jimma, Ethiopia. 3Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. 4Department of Internal Medicine, Jimma University, Jimma, Ethiopia. 5Department of Psychiatry, Jimma University, Jimma, Ethiopia. 6Department of Health Service Management, Jimma University, Jimma, Ethiopia. 7Armauer Hansen Research Institute, Addis Ababa, Ethiopia. 8Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium. Authors’ contribution GA was involved in the conception and design of the study, coordinated the field work, analyzed the data and drafted the manuscript. AD was involved in the conception, design of the study, field work and review of the article. LA was involved in the design and reviewed the article. AA, FD, KW, CJ, MT, JS, AAseffa and MB participated in the design, field work and reviewed the article. MB and AB participated in lab work and reviewed the article. RC participated in the design, critically reviewed and approved the article. All authors read and approved the final manuscript. Received: 19 February 2012 Accepted: 6 July 2012 Published: 6 July 2012 References 1. Ilgazli A, Boyaci H, Basyigit I, Yildiz F: Extrapulmonary tuberculosis: clinical and epidemiologic spectrum of 636 cases. Arch Med Res 2004, 35:435–441. 2. Weis SE, Moonan PK, Pogoda JM, Turk L, King B, Freeman-Thompson S, Burgess G: Tuberculosis in the foreign-born population of Tarrant county, Texas by immigration status. Am J Respir Crit Care Med 2001, 164:953–957. 3. 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