Demographic characteristics of patients with extrapulmonary tuberculosis in Germany

Forssbohm, M; Zwahlen, Marcel; Loddenkemper, R.; Rieder, Hans L.

doi:10.1183/09031936.00020607

Cited by 140 publications

(139 citation statements)

References 26 publications

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“…The association between sex and having EPTB alone is consistent with the findings from previous studies. 5,6,16,26 However, our observation that females had a significantly decreased likelihood of having EPTB plus PTB is new. The observed different effects of sex on having EPTB alone and having EPTB plus PTB are intriguing and warrant further investigations to gain a better understanding of the reasons for the observed variation in the sex effect between EPTB alone and EPTB plus PTB.…”

Section: Discussioncontrasting

confidence: 39%

See 1 more Smart Citation

Effect of Sex, Age, and Race on the Clinical Presentation of Tuberculosis: A 15-Year Population-Based Study

Zhang¹,

Andersen²,

Lillebæk³

et al. 2011

The American Journal of Tropical Medicine and Hygiene

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Abstract. Extrapulmonary tuberculosis (EPTB) is an important health problem that may cause serious morbidity and diagnostic challenges. We conducted a case-control study involving 5,684, approximately 99% of bacteriologically confirmed TB patients (including 1,925 EPTB cases) diagnosed in Denmark and Greenland during 1992-2007 to gain insight to the role of host factors in EPTB pathogenesis. Among patients from Somalia and Asia, persons 25-44 and 45-64 years of age were more likely to have EPTB than persons 15-24 years of age. In contrast, among persons from Greenland, the two oldest age groups were significantly less likely to have EPTB than the youngest age group. For all the age groups, the odds for having EPTB was significantly higher among patients from Somalia and Asia and significantly lower among the patients from Greenland than among patients from Denmark. Furthermore, the occurrence of specific types of EPTB significantly varied among different age groups or origins. International Reference Laboratory of Mycobacteriology is the only laboratory in Denmark that performs mycobacterial culturing confirming TB diagnosis to assist in the national TB surveillance system. For the present study, a database without identifiers of the study subjects was used. This study was reviewed and approved by the health sciences institutional review board of the University of Michigan, the Danish National Ethical Committee, and the Danish Data Protection Agency.Study design and case definitions. This study is a casecontrol study aiming at characterizing TB patients with different anatomic site involvement and identifying risk factors for having EPTB. On the basis of the origin of the specimens and clinical manifestations, the study patients were diagnosed as having pulmonary TB, extrapulmonary TB, or both. For this study, patients with TB exclusively in their lungs were classified as pulmonary TB (designated PTB). Patients with EPTB were categorized into two subgroups (EPTB alone and EPTB plus PTB) on the basis of whether they had TB exclusively at extrapulmonary tissue or organs or in pulmonary and extrapulmonary sites. These three groups were generated to compare the distribution of demographic characteristics between the PTB group and the EPTB alone group, and between the PTB group and the EPTB plus PTB group. In addition, patients with EPTB were grouped into seven categories, according to the classification of EPTB by the American Thoracic Society and the Centers for Disease Control and Prevention.11 These seven categories (also called forms) include bone or/and joint TB, pleural TB, genitourinary TB, peritoneal TB, meningeal TB, lymphatic TB, and other. The distributions of the seven categories were compared between sexes, among different age groups, and between persons of different origins, respectively. Because of national legislation, we did not have access to HIV status of individual patients, but because TB is an acquired immunodeficiency syndrome disease (AIDS)-defining disease, we knew the annual number of HIV-...

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Section: Discussioncontrasting

confidence: 39%

“…EPTB was found to account for 21.6%, 27%, and 38% of all TB cases in studies conducted in Germany, 26 the United States, 6 and The Netherlands, respectively. 7 In these studies, the proportions of immigrants were 32.1%, 43% and > 50%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Effect of Sex, Age, and Race on the Clinical Presentation of Tuberculosis: A 15-Year Population-Based Study

Zhang¹,

Andersen²,

Lillebæk³

et al. 2011

The American Journal of Tropical Medicine and Hygiene

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“…It is seen in children with a lower frequency. Recently, Forssbohm et al [6] reported that in Germany, only 5% of peritoneal TB cases were children under 14 years old. In the US, peritoneal TB accounts 0.3% of all TB cases in children less than 20 years and median age in children was 13 years [7] .…”

Section: Discussionmentioning

confidence: 99%

Tuberculous peritonitis in children: Report of nine patients and review of the literature

Dinler¹,

Şensoy²,

Helek³

et al. 2008

WJG

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AIM:To present our experience with tuberculous peritonitis treated in our hospital from [2002][2003][2004][2005][2006][2007]. METHODS: We reviewed the medical records of 9 children with tuberculous peritonitis. RESULTS: Nine patients (5 boys, 4 girls) of mean age 14.2 years were diagnosed with peritoneal tuberculosis. All patients presented with abdominal distention. Abdominal pain was seen in 55.5% and fever in 44.4% of the patients. Four cases had coexisting pleural effusion and two had pulmonary tuberculosis with parenchymal consolidation. Ultrasonography found ascites with septation in 7 patients. Two patients had only ascites without septation. Ascitic fluid analysis of 8 patients yielded serum-ascite albumin gradients of less than 1.1 gr/dL. Laparoscopy and laparotomy showed that whitish tuberculi were the most common appearance. Adhesions were also seen in three cases. The diagnosis of peritoneal tuberculosis was confirmed histo-pathologically in 7 patients and microbiologically in two. Two patients had been diagnosed by ascitic fluid diagnostic features and a positive response to antituberculous treatment. All patients completed the antituberculous therapy without any complications. CONCLUSION: Tu b e rc u l o u s p e r i t o n i t i s h a s t o be clinically suspected in all patients with slowly progressive abdominal distension, particularly when it is accompanied by fever and pain. Laparoscopy and peritoneal biopsy are still the most reliable, quick and safe methods for the diagnosis of tuberculous peritonitis.

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“…According to the WHO, the Eastern Mediterranean region shows the highest incidence of EPTB in the world [1]. One possible assumption is that this high rate may related to the high probability of reactivation of latent infection, particularly among migrantreceiving countries [15]. On the other hand, another unexplored possibility is related to the host genetic factors, as all the Arab counties are prone to genetic disorders and related complications mainly because of the high rate of consanguinity.…”

Section: Pulmonary Tb and Extrapulmonary Tbmentioning

confidence: 99%

Tuberculosis in Saudi Arabia: the journey across time

Al‐Hajoj

Varghese

2015

J Infect Dev Ctries

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Saudi Arabia is the third-largest Arab country with a moderate annual burden of tuberculosis. However, tuberculosis (TB) is among several infectious diseases that have not been brought under control, despite the government's considerable efforts. This is clearly evidenced by the ongoing transmission of several imported and indigenous clades of Mycobacterium tuberculosis. In addition, the country faces the threat from rising proportions of extrapulmonary TB, non-tuberculous mycobacterial infections, and drug resistance. Furthermore, the country falls behind the global targets set by World Health Organization for the success rate of TB treatment. The country needs more population-based research studies, centralized and easily accessible clinical data registries, and centralized research and diagnostic facilities. This review focused on the trends of mycobacterial infections and on future proposals to improve TB control measures in Saudi Arabia.

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Demographic characteristics of patients with extrapulmonary tuberculosis in Germany

Cited by 140 publications

References 26 publications

Effect of Sex, Age, and Race on the Clinical Presentation of Tuberculosis: A 15-Year Population-Based Study

Effect of Sex, Age, and Race on the Clinical Presentation of Tuberculosis: A 15-Year Population-Based Study

Tuberculous peritonitis in children: Report of nine patients and review of the literature

Tuberculosis in Saudi Arabia: the journey across time

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