Incidence of and Risk Factors Associated with Pulmonary and Extra-Pulmonary Tuberculosis in Saudi Arabia (2010–2011)

Memish, Ziad A.; Bamgboye, E. A.; Abuljadayel, Naila; Smadi, Hanan; Abouzeid, Mohamed Salamh; Hakeem, Rafat Faisal Al

doi:10.1371/journal.pone.0095654

Cited by 23 publications

(25 citation statements)

References 10 publications

(11 reference statements)

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“…Pleural TB existed as the second most common form followed by central nervous system and osteoarticular TB in most of the countries [ 23 ]. A recent Saudi Arabian study that was conducted in 2010–2011on nationwide coverage also reported high prevalence of lymphatic TB followed by bone, nervous and gastrointestinal systems among the studied population [ 24 ], a finding slightly deviating from this present study. However, the difference in representation of infection sites in both studies may be mostly related to the sample selection strategy used as the current study was based only on culture positive cases.…”

Section: Discussioncontrasting

confidence: 94%

Exploring the Sociodemographic and Clinical Features of Extrapulmonary Tuberculosis in Saudi Arabia

et al. 2015

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BackgroundSaudi Arabia annually reports a relatively higher proportion (28–32%) of extrapulmonary tuberculosis (EPTB) cases in comparison to other global regions. However, there were few studies conducted so far to determine the sociodemographic factors and clinical manifestations associated with EPTB at a nationwide level.MethodologyA retrospective analysis on culture positive EPTB isolates collected from all the provinces of the country were conducted for a period of 12 months to determine the spectrum of diversity in EPTB infection sites and the confounding factors. A detailed clinical and demographical data analysis was carried out along with first line drug susceptibility testing.Principal FindingsIntra-thoracic and extra-thoracic lymph nodes (44.6%) were the most common sites of infection followed by gastrointestinal (17.3%) and central nervous systems (11.8%). Male patients were mostly infected (58.8%), in contrary to the global trend. Any drug resistance was observed in 23.1% isolates with a 2.1% of multi-drug resistance. HIV reactivity was found only in 2.2% cases. A higher proportion of Saudi nationals (58.8%) were infected compared to the immigrants, descending mostly from South Asia (34.4%) and South East Asia (31.2%). The Saudi population predominated with all forms of EPTB while immigrants showed no significant variations.ConclusionsSaudi Arabia faces a serious threat from EPTB, particularly to the central nervous system and gastrointestinal systems. More effective diagnostic strategies and control measures must be implemented to reduce the high rate of EPTB in the country. In addition, these findings warrant further detailed research to explore all related comorbid conditions of EPTB development, particularly the host-related factors.

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Section: Discussioncontrasting

confidence: 94%

Exploring the Sociodemographic and Clinical Features of Extrapulmonary Tuberculosis in Saudi Arabia

et al. 2015

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“…A previous study from KSA found that extrapulmonary TB is present in 57.5% of all tuberculosis cases in a Teaching hospital in Al Riyadh through the period from 2001 to 2007 [ 24 ]. However, in a more recent study also from KSA, the proportion of extrapulmonary TB was found to be 32% in 2011 which is higher than global figures [ 25 ] with intra-thoracic and extra-thoracic lymph nodes being the most common sites of infection [ 26 ]. Extrapulmonary TB represented 28.2% of all reported TB cases in 1997 [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Burden of Multidrug Resistant Mycobacterium tuberculosis Among New Cases in Al-Madinah Al-Monawarah, Saudi Arabia

Elhassan

Hemeg

Elmekki

et al. 2017

IDDT

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Background:The pattern of Mycobacterium tuberculosis susceptibility to first line drugs and multidrug resistance in Al-Madinah Al-Munawarah, a seasonally overcrowded are during Hajj and Omrah, is not well studied.Objective:This study aimed to investigate anti-tuberculosis drug resistance and its distribution among new cases in Al-Madinah Al-Monawarah.Methods:Study subjects included 622 patients with first time confirmed TB referred to the central tuberculosis laboratory in Al-Madinah between January 2012 and December 2014.Results:Out of the 622 isolates, 99 (15.9%) were Mycobacteria Other Than Tuberculosis (MOTTS) and 25 (4.0%), three of which (12%) were children under five years of age, revealed multidrug resistance (MDR). Monoresistance to isoniazid (H) was (1.8%), to rifampin (R) was (1.4%), to streptomycin (S) was (1.9%) to ethambutol (E) was (1.1%) and to pyrazinamide (Z) was (2.1%).Conclusion:Being among the new cases, multidrug resistant tuberculosis (MDR TB) is supposed to be caused by strains which are originally multidrug resistant. Neither nationality nor gender was found to be associated with MDR TB. Since 12% of MDR cases were among children, a probability of primary infection with MDR strains is to be considered. Moreover, mass gathering during Hajj and Omrah seasons does not seem to increase the burden of MDR in the region. However, further investigation is needed to molecularly characterize MDR isolates and their phylogenetics and geographical origin.

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“…To investigate the independent risk factors associated with active TB infection during anti-TNF therapy, a logistic regression analysis was performed using variables with statistically significant associations identified in a univariate analysis. Age and sex were also included as variables for a multivariate analysis because these are considered important risk factors of TB infection [19,20] . A two-tailed P value < 0.05 was considered significant.…”

Section: Discussionmentioning

confidence: 99%

Significant risk and associated factors of active tuberculosis infection in Korean patients with inflammatory bowel disease using anti-TNF agents

Kim

Song

Cho

et al. 2015

WJG

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AIM:To evaluate the incidence and risk factors of Korean tuberculosis (TB) infection in patients with inflammatory bowel disease (IBD) undergoing anti-TNF treatment. METHODS:The data of IBD patients treated with anti-TNFs in 13 tertiary referral hospitals located in the southeastern region of Korea were collected retrospectively. They failed to show response or were intolerant to conventional treatments, including steroids or immunomodulators. Screening measures for latent TB infection (LTBI) and the incidence and risk factors of Retrospective Study ORIGINAL ARTICLEactive TB infection after treatment with anti-TNFs were identified. RESULTS:Overall, 376 IBD patients treated with anti-TNF agents were recruited (male 255, mean age of anti-TNF therapy 32.5 ± 13.0 years); 277 had Crohn's disease, 99 had ulcerative colitis, 294 used infliximab, and 82 used adalimumab. Before anti-TNF treatment, screening tests for LTBI including an interferon gamma release assay or a tuberculin skin test were performed in 82.2% of patients. Thirty patients (8%) had LTBI. Sixteen cases of active TB infection including one TB-related mortality occurred during 801 personyears (PY) follow-up (1997.4 cases per 100000 PY) after anti-TNF treatment. LTBI (OR = 5.76, 95%CI:1.57-21.20, P = 0.008) and WBC count < 5000 mm 3 (OR = 4.5, 95%CI: 1.51-13.44, P = 0.007) during follow-up were identified as independently associated risk factors. CONCLUSION:Anti-TNFs significantly increase the risk of TB infection in Korean patients with IBD. The considerable burden of TB and marked immunosuppression might be attributed to this risk.

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Incidence of and Risk Factors Associated with Pulmonary and Extra-Pulmonary Tuberculosis in Saudi Arabia (2010–2011)

Cited by 23 publications

References 10 publications

Exploring the Sociodemographic and Clinical Features of Extrapulmonary Tuberculosis in Saudi Arabia

Exploring the Sociodemographic and Clinical Features of Extrapulmonary Tuberculosis in Saudi Arabia

Burden of Multidrug Resistant Mycobacterium tuberculosis Among New Cases in Al-Madinah Al-Monawarah, Saudi Arabia

Significant risk and associated factors of active tuberculosis infection in Korean patients with inflammatory bowel disease using anti-TNF agents

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