Head and Neck Tuberculosis in Southeastern Region in Turkey, Near the Syrian Border

Abstract views: 99 / PDF downloads: 86





head and neck, tuberculosis, lymphadenitis, Immigrant


Objective: The study was conducted to evaluate profiles, demographical data, diagnostic, clinical and treatment approaches in relation to the cases of diagnosed head and neck tuberculosis after the start of the Syrian civil war in 2011. The aim of the study is to share current knowledge on head and neck tuberculosis and to investigate whether there is an epidemiological change with the admission of immigrants after the start of the Syrian civil war.

Methods: Demographic data, contact history, relapse, localization, tuberculin test, BCG vaccination and treatment duration are evaluated variables. Two groups were created. The first group was diagnosed with head and neck tuberculosis between 2006 and 2011 before the outbreak of the Syrian civil war, and the second group was diagnosed between 2012 and 2017 after the war in Syria caused hundreds of thousands of Syrian citizens to flee their homes and cross the border into Turkey.

Results: Head and neck tuberculosis cases tend to increase after the year of 2012. The number of diagnosed non-Turkish citizens expand after the year of 2012 and reach the highest number in 2017. BCG vaccination status and contact history were found to be the only variables that display statistical significance between the groups.

Conclusions: The number of head and neck tuberculosis cases increased after the Syrian war began due to insufficient rates of vaccination among the Syrian population and this population’s overcrowded living environment in Turkey. The burden of these crises affects a region rather than the whole country.


Metrics Loading ...


Khuzwayo ZB, Naidu TK (2014) Head and neck tuberculosis in Kwazulu-natal, South Africa. The Journal of Laryngology & Otology. 128(1):86-90. https://doi.org/10.1017/S0022215113003435

World Health Organization. Global tuberculosis report 2019. WHO global TB program; 2019 Oct [Internet] [cited 2019 Nov 11]. Available from: https://apps.who.int/iris/rest/bitstreams/1257851/retrieve

Hitit GÖ, Göktaş P, Erdem İ, Özyürek SÇ, Yüksel S (2005) Extra-Pulmonary Tuberculosis In Adults: An Analysis Of 67 Cases [Erişkinde 67 Akciğer dışı Tüberküloz Olgusunun Değerlendirilmesi]. Turkish Journal of Infection. 19:407-413 [In Turkish]

Mro´wka-Kata K, Namysłowski G, Czecior E, Sowa P, Iwańska J (2012) An updated view on tuberculous lymphadenitis in the context of HIV epidemic as well as multi drug and extensively drug-resistant tuberculosis. Otolaryngologia Polska. 66:176-180. https://doi.org/10.1016/S0030-6657(12)70765-5

Beyene D, Ashenafi S, Yamuah L, Aseffa A, Wiker H, et al (2008) Diagnosis of tuberculous lymphadenitis in Ethiopia: correlation with culture, histology and HIV status. International Journal of Tuberculosis and Lung Disease.12:1030-1036.

Handa U, Mundi I, Mohan S (2012) Nodal tuberculosis revisited: a review. The Journal of Infection in Developing Countries. 6:6-12. https://doi.org/10.3855/jidc.2090

Al-Serhani AM (2001) Mycobacterial infection of the head and neck: presentation and diagnosis. Laryngoscope. 111:2012-2016. https://doi.org/10.1097/00005537-200111000-00027

Chao SS, Loh KS, Tan KK, Chong SM (2002) Tuberculous and nontuberculous cervical lymphadenitis: a clinical review. Otolaryngol Head Neck Surgery. 126:176-179. https://doi.org/10.1067/mhn.2002.121912

Munck K, Mandpe AH (2003) Mycobacterial infections of the head and neck. Otolaryngologic Clinics of North America. 36:569-576. https://doi.org/10.1016/s0030-6665(03)00032-x

Nalini B, Vinayak S (2006) Tuberculosis in ear, nose, and throat practice: its presentation and diagnosis. American Journal of Otolaryngology. 27:39-45. https://doi.org/10.1016/j.amjoto.2005.07.005

Sayın I, Biskin S, Cakabay TT, Yazici ZM, Meric A, Kayhan F (2010) Tuberculous lymphadenitis [Tüberküloz lenfadenitleri]. Journal of Ear, Nose, and Throat. 20(4):184-190 [In Turkish]

Bayazit YA, Bayazit N, Namiduru M (2004) Mycobacterial cervical lymphadenitis. ORL; journal for oto-rhino-laryngology and its related specialties. 66:275-280. https://doi.org/10.1159/000081125

Vayisoğlu Y, Unal M, Ozcan C, Görür K, Horasan ES, Sevük L (2010) Lesions of tuberculosis in the head and neck region: a retrospective analysis of 48 cases [Baş boyun bölgesi tüberküloz lezyonları: 48 olgunun geriye dönük analizi]. Journal of Ear, Nose, and Throat. 20(2):57–63 [In Turkish]

United Nations Educational, Scientific and Cultural Organization (UNESCO). The 2013-2014 Lebanon Millennium Development Goals Report Was Produced with Financial Assistance from the United Nations Development; Beirut, 2013 [Internet] [cited 2019 Dec 15]. Available from: https://planipolis.iiep.unesco.org/en/2013/lebanon-millennium-development-goals-report-2013-2014-6045

Doganay M, Demiraslan H (2016) Refugees of the Syrian Civil War: Impact on Reemerging Infections, Health Services, and Biosecurity in Turkey. Health Security. 14:220–225. https://doi.org/10.1089/hs.2016.0054

Ismail MB, Rafei R, Dabboussi,F. Hamze M (2018) Tuberculosis, war, and refugees: spotlight on the Syrian humanitarian crisis. PLoS pathogens. 14(6), e1007014. https://doi.org/10.1371/journal.ppat.1007014

Republic of Turkey Prime Ministry AFAD (Disaster and Emergency Management Presidency). Syrian Refugees in Turkey; Ankara,2013. [Internet] [cited 2019 Dec 15]. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/AFADSurveyonSyrianRefugeesinTurkey2013.pdf [In Turkish]

Ozaras R, Leblebicioglu H, Sunbul M, Tabak F, Balkan II, et al (2016) The Syrian conflict and infectious diseases. Expert Review of Anti-infective Therapy. 14(6):547-555. https://doi.org/10.1080/14787210.2016.1177457

D’Ambrosio L, Centis R, Dara M, Solovic I, Sulis G, et al (2017) European policies in the management of tuberculosis among migrants. International Journal of Infectious Diseases. 56:85-89. https://doi.org/10.1016/j.ijid.2016.11.002

Parusharam N, Reddy KA, Magar LR, Lingaiah J (2015) Primary tuberculosis of tonsil in a diabetic patient - A case report. Int J Otolaryngol Head Neck Surg. (4);190-195. https://doi.org/10.4236/ijohns.2015.43032

Izudi J, Semakula D, Sennono R, Tamwesigire IK, Bajunirwe F (2019) Treatment success rate among adult pulmonary tuberculosis patients in sub-Saharan Africa: a systematic review and meta-analysis. BMJ Open. 9:e029400. https://doi.org/10.1136/bmjopen-2019-029400

Luca S, Mihaescu, T (2013) History of BCG vaccine. Maedica. 8(1):53-58.

T.C. Sağlık Bakanlığı. Tüberküloz Tanı ve Tedavi Rehberi. Ankara, 2019. [Internet] [cited 2019 Nov 11]. Available from: from: https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Tuberkuloz_Tani_Ve_Tedavi_Rehberi_/Tuberkuloz_Tani_ve_Tedavi_Rehberi.pdf [In Turkish]

Storgaard L, Rodrigues A, Martins C, et al (2015) Development of BCG Scar and Subsequent Morbidity and Mortality in Rural Guinea-Bissau. Clinical Infectious Diseases. 61: 950-959. https://doi.org/10.1093/cid/civ452

Trunz BB, Fine P, Dye C (2006) Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness Lancet. 367:1173-1180. https://doi.org/10.1016/S0140-6736(06)68507-3

GHO | By category | BCG - Immunization coverage estimates by country. WHO, 2019. [Internet] [cited 2019 Nov 11]. Available from: https://apps.who.int/gho/data/node.main.A830?lang=en

Smaoui S, Mezghanni MA, Hammami B, Zalila N. et al (2015) Tuberculosis lymphadenitis in a south eastern region in Tunisia: epidemiology, clinical features, diagnosis and treatment. International Journal of Mycobacteriology. 4:196-201. https://doi.org/10.1016/j.ijmyco.2015.04.004

Ammari FF, Bani Hani AH, Ghariebeh KI (2003) Tuberculosis of the lymph glands of the neck: a limited role for surgery. Otolaryngology Head Neck Surgery. 128:576-580. https://doi.org/10.1016/S0194-59980300121-9

Baskota DK, Prasad R, Kumar Sinha B, Amatya RC (2004) Distribution of lymph nodes in the neck in cases of tuberculous cervical lymphadenitis. Acta Oto-Laryngologica. 124: 1095-1098. https://doi.org/10.1080/00016480410018089

Sheikh NT, Akhtar S, Tabassum S, ul Khurshid S (2021) Role of tuberculin skin test (Mantoux test) as an aid in the diagnosis of tuberculosis disease and to identify persons with latent tuberculosis in highly endemic hilly region of Jammu and Kashmir. Eastern Journal of Medical Sciences. 31-35. https://doi.org/10.32677/EJMS.2021.v06.i01.007

Chan AB, Ma TK, Yu BK, King AD, Ho FN, et al (2004) Nasopharyngeal granulomatous inflammation and tuberculosis complicating undifferentiated carcinoma. Otolaryngology Head Neck Surgery. 130:125-130. https://doi.org/10.1016/j.otohns.2003.08.014

Ibekwe AO, al Shareef Z, al Kindy S (1997) Diagnostic problems of tuberculous cervical adenitis (scrofula). American Journal of Otolaryngology. 18:202-205. https://doi.org/10.1016/S0196-0709(97)90083-1




How to Cite

Tümüklü, K., Aytaç, İsmail, Yazıcı, A., & Aytaç, S. (2023). Head and Neck Tuberculosis in Southeastern Region in Turkey, Near the Syrian Border. European Journal of Therapeutics, 256–263. https://doi.org/10.58600/eurjther1624



Original Articles