Abebe et al. BMC Public Health 2012, 12:504 http://www.biomedcentral.com/1471-2458/12/504 R E S E A R C H A R T I C L E Open Access Tuberculosis lymphadenitis in Southwest Ethiopia: a community based cross-sectional study Gemeda Abebe1,8*, Amare Deribew2,8, Ludwig Apers3, Alemseged Abdissa1, Fetene Deribie1, Kifle Woldemichael2, Jaffer Shiffa4, Markos Tesfaye5, Chali Jira6, Mesele Bezabih1, Abraham Aseffa7, Alemayehu Bekele1 and Robert Colebunders3,8 Abstract Background: In Ethiopia where there is no strong surveillance system and diagnostic facilities are limited, the real burden of tuberculosis (TB) lymphadenitis is not well known. Therefore, we conducted a study to estimate the prevalence of TB lymphadenitis in Southwest Ethiopia. Methods: A community based cross-sectional study was conducted from February to March 2009 in the Gilgel Gibe field research area. A total of 30,040 individuals 15 years or older in 10,882 households were screened for TB lymphadenitis. Any individual 15 years or older with lumps in the neck, armpits or groin up on interview were considered TB lymphadenitis suspect. The diagnosis of TB lymphadenitis was established when acid fast bacilli (AFB) smear microscopy of fine needle aspiration (FNA) sample, culture or cytology suggested TB. HIV counseling and testing was offered to all TB lymphadenitis suspects. Descriptive and bivariate analysis was done using SPSS version 15. Results: Complete data were available for 27,597 individuals. A total of 87 TB lymphadenitis suspects were identified. Most of the TB lymphadenitis suspects were females (72.4%). Sixteen cases of TB lymphadenitis were confirmed. The prevalence of TB lymphadenitis was thus 58.0 per 100,000 people (16/27,597) (95% CI 35.7-94.2). Individuals who had a contact history with chronic coughers (OR 5.58, 95% CI 1.23-25.43) were more likely to have TB lymphadenitis. Lymph nodes with caseous FNA were more likely to be positive for TB lymphadenitis (OR 5.46, 95% CI 1.69-17.61). Conclusion: The prevalence of TB lymphadenitis in Gilgel Gibe is similar with the WHO estimates for Ethiopia. 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 lymphadenitis suspects using simple methods. Keywords: TB lymphadenitis, Prevalence, Jimma, Ethiopia Background TB lymphadenitis is the most common form of extrapul- monary TB [1]. Its epidemiology and diagnostic aspects vary according to the patients’ geographic origin and the burden of TB and HIV infection [2]. Globally the inci- dence of all forms of TB is decreasing. However, the rate * Correspondence: gemeda.abebe@ju.edu.et 1Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia 8Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium Full list of author information is available at the end of the article is not similar across all WHO regions. In the Africa re- gion it is decreasing slowly by 1.8% per year [3]. Ethiopia is among the 22 high TB burden countries in the world. The proportion of extrapulmonary TB among newly diagnosed TB patients has been increasing for the last two decades [3]. The WHO and the Ethiopian TB control program estimate that the proportion of extra- pulmonary TB among the total number of new TB cases (156,928) is about 32% [4,5]. The majority of extrapul- monary TB cases present with TB lymphadenitis. How- ever, the real burden of pulmonary TB and extrapulmonary TB in Ethiopia is not known at © 2012 Abebe et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.