Epidemiology of tuberculosis based on histopathological data and nucleic acid amplification techniques in Lebanon from January 2012 to December 2016

Background: Tuberculosis (TB) is a worldwide disease caused by Mycobacterium tuberculosis with significant morbidity and mortality. It has variable presentations and is also influenced by host factors including immune function. Lebanon is considered to have low prevalence of this disease but has been experiencing fluctuating numbers due to several variables, migration speculated to be one of those. Our objective was to determine the epidemiology of TB in Lebanon in the interval spanning from January 2012 to December 2016. We also aimed to compare the trend of TB incidence with the trends of Syrian and foreign-worker migration. Methods: We included 312 TB-positive patients from the National Institute of Pathology (INP) in the interval mentioned above. We studied distribution according to gender, age, regions, and the site involved. Results: Our study showed greatest distribution of TB in Mount Lebanon (42.7%), more cases of extrapulmonary TB, higher incidence in females, and a mean age of 38.5 years. New TB cases increased over the years to a maximum of 69 in 2015 then decreased to 61 in 2016. This trend was similar to the trend of Syrian migration with statistically significant positive correlation. Conclusion: There was a relationship between the Syrian migration and the increase in TB cases in Lebanon likely due to overburdening the screening protocols. We thus emphasize on the importance of the screening regimens, and enhancing and implementing them