Epidemiological and clinicopathological aspects of female genital tuberculosis in Antananarivo, Madagascar
- MOJ Women's Health
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Ranaivomanana VF, Ranaivoson HVR, Andrianjafitrimo HT, Randrianjafisamindrakotroka NS
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Abstract
Genital tuberculosis constitutes a form of extrapulmonary tuberculosis that remains largely underrecognized, particularly in low-income countries such as Madagascar. In these settings, diagnosis is frequently delayed, despite the potential for severe consequences on women’s health, ranging from menstrual disturbances and infertility to malignant transformation.
The aim of this study is to describe the epidemiological, clinical, and morphological characteristics of female genital tuberculosis in the local context, with the aim of improving diagnosis and preventing unnecessary radical treatment, particularly in young patients. This was a retrospective, descriptive study of female genital tuberculosis cases over a five-and-a-half-year period, from July 2019 to December 2024, conducted at the Department of Anatomical Pathology of the Joseph Ravoahangy Andrianavalona University Hospital Center. During the study period, 12 cases were identified. The patients’ ages ranged from 17 to 60 years, with a mean age of 42.2 ± 15.3 years. The most common site of involvement was the fallopian tubes, accounting for 50% of cases. In 58.3% of cases, the morphological pattern was typical, consisting of epithelioid granulomas with Langhans-type giant cells centered on caseous necrosis. The lesions were associated with a high-grade squamous intraepithelial lesion (CIN 2), an endometrioid adenocarcinoma of the endometrium, and a bilateral mucinous ovarian adenocarcinoma. From an evolutionary standpoint, the lesions were predominantly observed at a chronic stage, characterized by fibrotic remodeling, extension of the lesions into the abdominal cavity, and instances of malignant transformation. Epithelial alterations with ciliary loss and fusion of tubal fimbriae were also documented. The findings of this study may contribute to the development of more appropriate screening protocols, strengthen the capacities of healthcare professionals, and improve access to specialized care for affected patients. This research therefore aligns with broader efforts to combat tuberculosis and promote reproductive health.
Keywords
antananarivo, madagascar, tuberculosis, reproductive health
