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Browsing Student Submissions by Author "Rawan Moraweh Hussein Abdelhaq"

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    Prevalence and Risk Factors of Tuberculosis in the West Bank (2016-2024)
    (Al-Quds Univeersity, 2026-01-10) Rawan Moraweh Hussein Abdelhaq; روان مروح عبد الحق
    Background: Tuberculosis (TB) remains a significant global public health concern, including in low-incidence but high-risk settings such as Palestine, where political constraints, limited diagnostic capacity, and socioeconomic hardship may mask the true burden of disease. Although the West Bank reports fewer than one case per 100,000 population, the actual burden may be underestimated due to diagnostic limitations, underreporting, and operational constraints within the health system. Understanding the epidemiological trends, risk factors, clinical characteristics, and household transmission patterns is essential to strengthening surveillance and improving TB control strategies. Methodology: A retrospective descriptive study was conducted using national TB surveillance data obtained from the Palestinian Ministry of Health for the years 2016–2024. Data were extracted from standardized investigation forms and DHIS2 databases. Descriptive statistics and bivariate analyses were performed to assess sociodemographic, socioeconomic, clinical, diagnostic, and household contact variables, and to determine factors associated with TB forms and diagnostic outcomes. Results: From 2016 to 2024, a total of 67 confirmed TB cases (49 PTB and 18 EPTB) aged ≥10 years were reported in the West Bank, corresponding to a very low but fluctuating incidence of 0.09-0.36 per 100,000 population and an overall prevalence of 2.01 per 100,000. Cases were predominantly male (65.7%) with a median age of 47 years; PTB was more common among older adults, whereas EPTB was relatively more frequent in younger adults. Bivariate analysis showed that occupation (notably doctors and digger-truck drivers) was significantly associated with TB classification (p = 0.026). At the same time, sex, housing conditions, and diagnostic delays were statistically associated with higher bacteriological positivity in selected tests, reflecting increased infectiousness in specific subgroups. Diagnostic pathways relied mainly on acid fast stain, culture, imaging, and Mantoux testing, with minimal use of GeneXpert and substantial underreporting of several diagnostic results and comorbidities. Among 139 household contacts, 23.1% had a positive Mantoux test. However, tuberculosis preventive therapy was documented for only about two-thirds of eligible contacts, and overall treatment outcomes for index cases were poorly recorded. Conclusion: Although TB incidence in the West Bank remains low, the study highlights key epidemiological and clinical patterns that warrant attention, including occupational-related risks, diagnostic delays, and potential household transmission. Strengthening diagnostic capacity, enhancing early detection, improving documentation quality, and implementing targeted prevention strategies may help reduce future TB burden and support national progress toward the WHO End TB goals.