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Tuberculosis (TB) is a significant global public health concern. The incidence of extrapulmonary tuberculosis (EPTB) is increasing; however, comprehensive data on its epidemiological and clinical characteristics remain limited, especially among populations who are co-infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV). This study aimed to assess the incidence and predictors of EPTB in patients co-infected with HIV or HCV in Egypt. We conducted a retrospective cohort study on patients infected with TB who are treated in Egyptian chest hospitals from January 1 to December 31, 2023. Patients were categorized into pulmonary TB (PTB) and EPTB. Clinical data, including HIV or HCV co-infection status, were analyzed to identify risk factors and comorbidities associated with EPTB. Multilevel logistic regression was employed to examine predictors of EPTB. Among 7,245 TB patients, 42.5% were diagnosed with EPTB. Determinant of EPTB were HIV-positive (OR = 0.46, 95% CI: 0.30–0.71, p  < 0.001), being male (OR = 0.31, 95% CI: 0.27–0.35, p  < 0.001 ), age (particularly children under 5 years) (OR = 4.75, 95% CI: 2.29–9.84, p  < 0.001 ), urban residency (OR = 1.05, 95% CI: 0.87–1.27, p  < 0.05), and comorbidities (OR = 0.59, 95% CI: 0.35–0.98, p  < 0.05). The most common sites for EPTB were the lymph nodes (27.10%) and pleural cavity/effusion (24.60%). EPTB represents a substantial proportion of TB cases in Egypt, particularly among younger individuals and females. Despite the low percentage of HIV or HCV co-infection in EPTB cases, further analysis and diagnostic testing of undiagnosed patients are required. These findings underscore the need for targeted interventions and comprehensive care models for TB patients, especially in the context of HIV co-infection.

This study aimed to identify the characteristics and predictors of coronavirus disease (COVID-19)-related maternal deaths in 2020 and 2021, and to assess maternal mortality ratio (MMR) from 2018 to 2021 in Egypt. A record-based cross-sectional analytical study was conducted in four randomly selected governorates: Kafr El-Sheikh, El-Behira, (Lower Egypt) and Assiut, and Fayoum (Upper Egypt). Data from 541 maternal deaths were analyzed, revealing that 37.7% occurred in Assuit, 28.5% in El-Behira, 22.7% in Fayoum, and 11.1% in Kafr El-Sheik. The mean age of the studied population was 28.9 ± 6.4 years, with 39.0% having 1–2 children and 26.8% being nulliparous. Direct causes, including postpartum haemorrhage, preeclampsia, and embolism, accounted for 47.5% of deaths. As one of indirect causes of deaths, COVID-19 was diagnosed in 25.3%, it was the sole cause in 75.0% of them. Multivariable analysis identified the year 2021 (adjusted odds ratio (aOR) = 3.32; 95% CI, 1.9–5.81), residence in Lower Egypt (aOR = 5.15; 95% CI, 2.61–10.18), and hospital referral refusals (aOR = 8.72; 95% CI, 1.73–44.0) as key predictors of COVID-19-associated MM. The overall MMR increased between 2018 and 2021 with significant increases observed in Fayoum (from 39.25 to 71.65; p  < 0.001) and Kafr El-Sheikh (from 36.44 to 56.6; p  = 0.032). Yearly comparisons revealed significant inter-governorate differences in all years except 2021 ( p  = 0.15), with Assuit maintaining the highest MMR. Although the national MMR increased from 44.1 (pre-COVID-19) to 55.9 (post-COVID-19), this change was not statistically significant ( p  = 0.236). The findings highlight an alarming rise in maternal deaths and underscore the need for targeted interventions to address the direct causes of MM and improve healthcare access during crises like the COVID-19 pandemic.