Title : Laboratory surveillance of tuberculosis in Morocco: A five-year retrospective analysis of laboratory data, 2021–2025

Background: Tuberculosis (TB) is a public health concern in Morocco. Institut Pasteur of Morocco (IPM) is a key diagnostic and advisory partner in the national programme.

Methods: This study described the epidemiological and clinical picture of culture confirmed TB cases referred to the laboratory between 2021-2025 through a retrospective, secondary study of all culture-confirmed tuberculosis cases referred to IPM Casablanca through the National Programme for Tuberculosis. Data were extracted from laboratory registers with variables capturing sex, geographic origin of samples, sample type and clinical category. Associations between sex, anatomical site, and case category were assessed using Fisher’s exact test and Chi square tests. Analyses were performed using R (v4.4).

Results: From 3,385 cultures performed, 17.0% (575) were positive, corresponding to 486 unique patients and an annual referral rate of 20.5 per 100000 population. Male sex predominated (82.7%; male-to-female ratio 4.8:1). Geographic origin was concentrated in Casablanca (62%).

Among the 409 records with a classified sample type, a statistically significant sex difference in anatomical site was highlighted: women were more likely to present with extra-pulmonary disease (7.4% vs 1.2%; Fisher's exact OR=6.44, p=0.006. Clinical information was available for 37% of records: relapse was the most frequent category (n=80, 23.5%), followed by treatment failure or drop out (n=43, 12.6%).

Conclusion: This study emphasises on the role of laboratory surveillance in detecting tuberculosis and monitoring drug resistance. It underscores the need to strengthen diagnostic capacity, drug resistance surveillance, and treatment adherence strategies to reach the WHO End TB targets 2030.

Keywords: Tuberculosis, laboratory, Mycobacterium tuberculosis, Morocco, infectious disease
 

Dr. Niloufer Khodabocus is an epidemiologist who has worked at national level in Mauritius. She holds a Masters in Public Health (epidemiology) from the Manipal Academy of Higher Education in India. Dr. Khodabocus has also worked in the field of HIV in civil society. She is currently a fellow of the African Epidemic Service Epidemiology Track , a programme of the African Union and Africa CDC geared to create a well-trained public health workforce in Africa. She is deployed in Morocco for field deployment.