Prevalence, Clinical Features and Factors Associated with Hypercalcemia Among Patients Diagnosed with Tuberculosis at Lira Regional Referral Hospital, Northern Uganda: A Cross-Sectional Study

Abdullahi Hussein Ahmed Jnr,1 Nixson Onyanga,1 Abdalla Ahmed Adam Deifa,1 Hassan Omar Ali,1 Fatima Ibrahim Nor,1 Zakarie Abdullahi Hussein,1 Abdijibar Mohamud Mohamed,2 Najma Ali Hashi,3 Mohamed Abdi Hassan,2 Abshir Mohamud Hirsi,1 Mohamed Jayte1 1Department of Internal Medicine, Faculty of Clinical Medicine and Dentistry, Kampala International University, Ishaka, Bushenyi, Uganda; 2Department of Pediatric and Child Health, faculty of clinical Medicine and Dentistry, Kampala International University, Ishaka, Bushenyi, Uganda; 3Department of Obstetrics and Gynecology, faculty of clinical Medicine and Dentistry, Kampala International University, Ishaka, Bushenyi, UgandaCorrespondence: Abdullahi Hussein Ahmed Jnr, Department of Internal Medicine, faculty of clinical Medicine and Dentistry, Kampala International University, Ishaka, Bushenyi, Uganda, Email abdullahiiadow@gmail.comBackground: Tuberculosis (TB) remains a leading cause of morbidity and mortality globally. Hypercalcemia, a recognized complication of TB, is often asymptomatic but may cause significant clinical consequences. In Uganda, routine screening for hypercalcemia in TB patients is limited, and data on its prevalence and associated factors are scarce. This study aimed to determine the prevalence, clinical features, and factors associated with hypercalcemia among TB patients at Lira Regional Referral Hospital (LRRH).Methods: A cross-sectional study was conducted among 180 adult TB patients attending the LRRH TB clinic. Socio-demographic, clinical, and laboratory data were collected using structured questionnaires. Total serum calcium was measured using colorimetric method, with hypercalcemia defined as adjusted calcium > 10.5 mg/dL. Logistic regression was used to identify factors independently associated with hypercalcemia, with significance set at p< 0.05.Results: Of the 180 participants (mean age 41.3± 15.7 years; 54.4% female), 50 had hypercalcemia, giving a prevalence of 27.8% (95% CI: 21.1– 34.4%). The most frequent symptoms associated with hypercalcemia were constipation (74.0%), polyuria (60.0%), and polydipsia (70.0%), all p< 0.05. Independent predictors of hypercalcemia included elderly age (aOR=3.075; 95% CI: 1.035– 7.139; p=0.043), HIV positivity (aOR=2.001; 95% CI: 1.254– 5.631; p=0.011), and elevated creatinine (aOR=3.648; 95% CI: 1.510– 6.517; p=0.006).Conclusion: The prevalence of hypercalcemia among TB patients in northern Uganda is high. Routine calcium screening should be considered, particularly among elderly patients, those with HIV infection, and those with renal impairment, to enable early detection and management.Keywords: tuberculosis, hypercalcemia, prevalence, HIV, renal impairment, Uganda, lira regional referral hospital