{
  "abstract": "Background: Extrapulmonary tuberculosis (EPTB) remains a major diagnostic challenge, particularly in resource-limited settings where tuberculosis services are often centred on pulmonary disease. This study assessed the burden, anatomical distribution, and clinical determinants of EPTB among patients treated at Hargeisa TB Hospital, Somaliland.\n\nMethods: A retrospective facility-based cross-sectional study was conducted using tuberculosis registry data from 2019–2024. All 7,211 registered TB patients were included. Missing data were handled using complete-case analysis, whereby participants with missing values for variables were excluded. Descriptive statistics summarized patient characteristics and EPTB sites, while logistic regression identified factors independently associated with EPTB. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported.\n\nResults: Of 7,211 patients, 3,123 (43.3%) had EPTB and 4,088 (56.7%) had pulmonary TB. Lymphatic TB was the most common specific anatomical form (25.5%), followed by pleural (17.9%), abdominal (15.8%), bone/spinal (14.1%), and meningeal TB (1.3%). Female sex was independently associated with EPTB (aOR = 1.77; 95% CI: 1.60–1.95). Compared with patients aged 0–14 years, higher odds were observed among those aged 15–34 years (aOR = 1.40; 95% CI: 1.23–1.59), 35–54 years (aOR = 2.11; 95% CI: 1.82–2.44), and ≥55 years (aOR = 1.84; 95% CI: 1.57–2.15). New TB cases were also associated with EPTB (aOR = 1.48; 95% CI: 1.21–1.82), whereas HIV-positive and on ART status was inversely associated (aOR = 0.37; 95% CI: 0.27–0.52). Reporting year was not significant.\n\nConclusion: EPTB constituted a substantial proportion of the TB burden at Hargeisa TB Hospital. Female sex, older ages, and HIV status were independent predictors. Strengthening EPTB-specific diagnostic pathways, referral systems, imaging, molecular testing, and histopathology is essential for improving case detection and TB control in Somaliland.",
  "abstract_shown": true,
  "affiliations": [
    "School of Postgraduate Studies and Research, Amoud University",
    "School of Graduate Studies and Research, Gollis University",
    "Faculty of Medicine and Health Sciences, University of Hargeisa",
    "Faculty of Statistics and Data Science, College of Business, Economics and Statistics, University of Hargeisa"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Abdirashid Muhumed Guled"
    },
    {
      "affs": [
        0
      ],
      "name": "Abdulkadir Mohamed Nuh"
    },
    {
      "affs": [
        1
      ],
      "name": "Mohamed Abdilahi Mohamed"
    },
    {
      "affs": [
        0
      ],
      "name": "Abdisalam Hassan Muse"
    },
    {
      "affs": [
        0
      ],
      "name": "Hamse Arab Ali"
    },
    {
      "affs": [
        2
      ],
      "name": "Hamse Adam Abdi"
    },
    {
      "affs": [
        3
      ],
      "name": "Mustafe Abdilahi Abdiqadir"
    },
    {
      "affs": [
        0
      ],
      "name": "Amani Yusuf Yonis"
    },
    {
      "affs": [
        0
      ],
      "name": "Omran Salih"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cmy5yn85jd7a7.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1982502",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727613/?tool=EBI",
  "id": "cmy5yn85jd7a7",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1982502/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2725|Tuberculosis Research and Epidemiology"
    ]
  ],
  "openalex": "W7223058085",
  "pdf_url": "https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1982502/pdf",
  "pmcid": "PMC13727613",
  "pmid": "42978708",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/cmy5yn85jd7a7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:24Z",
      "native_id": "10.3389/fpubh.2026.1982502",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1982502/full"
    },
    {
      "first_seen": "2026-11-04T15:20:45Z",
      "native_id": "PMC:PMC13727613",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727613"
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    {
      "first_seen": "2026-11-06T12:23:27Z",
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      "source": "pmc",
      "url": "https://doi.org/10.3389/fpubh.2026.1982502"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Tuberculosis Research and Epidemiology",
      "subfield": "infectious-disease"
    }
  ],
  "title": "High burden of extrapulmonary tuberculosis and its clinical determinants: a 6-year retrospective analysis of patients at Hargeisa TB Hospital, Somaliland",
  "title_text": "High burden of extrapulmonary tuberculosis and its clinical determinants: a 6-year retrospective analysis of patients at Hargeisa TB Hospital, Somaliland",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:23:27Z",
  "url": "https://research.draconitic.com/paper/cmy5yn85jd7a7",
  "venue": "Frontiers in Public Health",
  "versions": []
}