{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:14:53Z","timestamp":1792512893643,"version":"4.5.0"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The actual burden of bacteriologically confirmed extrapulmonary tuberculosis (EPTB) and risk factors in Ethiopia is not well known due to the lack of a strong surveillance system in Ethiopia. Thus, this study was conducted to estimate the pooled prevalence of bacteriologically confirmed EPTB and the associated risk factors among persons suspected to have non-respiratory tuberculosis in Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A systematic review and meta-analysis of published studies reporting the prevalence of EPTB from searched electronic databases; Science Direct, PubMed, and Google Scholar was estimated spread across the research periods, nationally, and in different areas, using a fixed-effects model. We used I<jats:sup>2<\/jats:sup> to analyze heterogeneity in the reported prevalence of bacteriologically confirmed extrapulmonary tuberculosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>After reviewing 938 research articles, 20 studies (19 cross-sectional and 1 retrospective) from 2003 to 2021 were included in the final analyses. The pooled prevalence of bacteriologically confirmed EPTB was 43% (95%CI; 0.34\u20130.52, I<jats:sup>2<\/jats:sup> = 98.45%). The asymmetry of the funnel plot revealed the presence of publication bias. Specifically the pooled prevalence of bacteriologically confirmed EPTB based on smear microscopy, Xpert MTB\/RIF assay, and culture were 22% (95%CI; 0.13\u20130.30, I<jats:sup>2<\/jats:sup> = 98.56%), 39% (95%CI; 0.23\u20130.54, I<jats:sup>2<\/jats:sup> = 98.73%) and 49% (95%CI; 0.41\u20130.57, I<jats:sup>2<\/jats:sup> = 96.43%) respectively. In this study, a history of pulmonary tuberculosis (PTB) contact with PTB patients, contact with live animals, consumption of raw milk, HIV-positive, male, and lower monthly income, were found to be independently associated with bacteriologically confirmed EPTB.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Ethiopia has a high rate of bacteriologically confirmed EPTB. A history of previous PTB, being HIV-positive and having contact with PTB patients were the most reported risk factors for EPTB in the majority of studies. Strengthening laboratory services for EPTB diagnosis should be given priority to diagnose EPTB cases as early as possible.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0276701","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T14:37:11Z","timestamp":1669300631000},"page":"e0276701","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Bacteriologically confirmed extrapulmonary tuberculosis and the associated risk factors among extrapulmonary tuberculosis suspected patients in Ethiopia: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0166-682X","authenticated-orcid":true,"given":"Getu","family":"Diriba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayinalem","family":"Alemu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirubel","family":"Eshetu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8505-7000","authenticated-orcid":true,"given":"Bazezew","family":"Yenew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinka Fikadu","family":"Gamtesa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habteyes 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Comparative performance of diagnostic tests for mycobacterial lymphadenitis in a high-burden country","volume":"41","author":"R Iwnetu","year":"2009","journal-title":"Scand J Infect Dis"},{"issue":"1","key":"pone.0276701.ref033","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3855\/jidc.2050","article-title":"Comparison of PCR with standard culture of fine needle aspiration samples in the diagnosis of tuberculosis lymphadenitis","volume":"6","author":"Y HE Derese","year":"2012","journal-title":"J Infect Dev Ctries"},{"key":"pone.0276701.ref034","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s12879-015-0846-7","article-title":"Investigation of the high rates of extrapulmonary tuberculosis in Ethiopia reveals no single driving factor and minimal evidence for zoonotic transmission of Mycobacterium bovis infection","volume":"15","author":"S Berg","year":"2015","journal-title":"BMC Infect Dis"},{"issue":"1","key":"pone.0276701.ref035","doi-asserted-by":"crossref","first-page":"100","DOI":"10.4103\/1755-6783.115207","article-title":"Extrapulmonary tuberculosis and HIV coinfection in patients treated for tuberculosis at the Douala General Hospital in Cameroon","volume":"6","author":"L Namme","year":"2013","journal-title":"Annals of Tropical Medicine and Public Health"},{"key":"pone.0276701.ref036","first-page":"225","article-title":"Prevalence of extrapulmonary tuberculosis among people living with HIV\/AIDS in sub-Saharan Africa: a systemic review and meta-analysis","volume":"10","author":"H Mohammed","year":"2018","journal-title":"HIV AIDS (Auckl)"},{"issue":"1","key":"pone.0276701.ref037","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1038\/s41426-018-0106-1","article-title":"Risk factors for extrapulmonary dissemination of tuberculosis and associated mortality during treatment for extrapulmonary tuberculosis","volume":"7","author":"X Qian","year":"2018","journal-title":"Emerg Microbes Infect"},{"issue":"12","key":"pone.0276701.ref038","doi-asserted-by":"crossref","first-page":"e0243945","DOI":"10.1371\/journal.pone.0243945","article-title":"Epidemiology and the diagnostic challenge of extra-pulmonary tuberculosis in a teaching hospital","volume":"15","author":"B Arega","year":"2020","journal-title":"Ethiopia. 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