Tuberculosis Prevalence in Forensic Autopsies

Özsoy, Sait; Demirel, Birol; Albay, Ali; Kısa, Özgül; Dinç, Ahmet; Safalı, Mükerrem

doi:10.1097/paf.0b013e3181c215f9

Cited by 21 publications

(12 citation statements)

References 8 publications

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“…7,8 The three cases of tuberculosis diagnosed at autopsy in Ankara, Turkey accounted for nearly 1% of the total number of 302 randomly studied cases. 9 A study conducted in Dublin, Ireland in a 14-year period from 1991 to 2004, during which 4930 autopsies were conducted, reported 10 cases of unsuspected tuberculosis diagnosed at autopsy. 10 Twenty one cases of tuberculosis diagnosed at autopsy were undiagnosed before death in a cohort of 13866 autopsies performed during the period January 1994 to June 2004 in Auckland, New Zealand.…”

Section: Discussionmentioning

confidence: 99%

“…12 Autopsy studies have been conducted in countries such as India, Turkey, Ireland and New Zealand to find the prevalence of previously undiagnosed cases of pulmonary tuberculosis. 6,[9][10][11] However, there is a lacuna in literature reported from Saudi Arabia regarding cases of tuberculosis identified for the first time during postmortem examination and therefore the present prospective, preliminary study was conducted.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary tuberculosis in a cohort of forensic autopsies: a preliminary study from Saudi Arabia

et al. 2020

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The purpose of this study was to identify any cases of previously undiagnosed pulmonary tuberculosis during autopsy. Methods: This prospective study investigated a cohort of deceased individuals that underwent a full external and internal postmortem examination at the Forensic Medicine Centre, Dammam, Saudi Arabia. Gross pathology, histopathology and molecular pathology were used to identify pulmonary tuberculosis in forensic autopsy samples from the lungs. Results: A total of 82 cases autopsied were included in the study. The mean AE SD age of the study cohort was 35.5 AE 10.3 years (range, 20-80 years). Males (n ¼ 70; 85.37%) outnumbered females. The deceased were from 15 different countries. The number of Saudis was 16 (19.51%). The maximum number of non-Saudis was from India with 26 cases (31.71%). There were no cases of undiagnosed pulmonary tuberculosis detected for the first time at autopsy. Conclusions: Although the prevalence of pulmonary tuberculosis in forensic autopsy cases in this preliminary study was nil, we recommend further studies to be conducted on a larger scale and in different autopsy centres throughout Saudi Arabia to get an insight into the burden of clinically undiagnosed tuberculosis in the entire country.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulmonary tuberculosis in a cohort of forensic autopsies: a preliminary study from Saudi Arabia

et al. 2020

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“…It has been estimated that up to 67% of cases may not be identified until the time of autopsy, with undiagnosed cases accounting for 74% of the total in Japan. [12][13][14] This places quite a burden on forensic workers who are clearly in danger of acquiring an infection from inhalation, ingestion or direct inoculation. 15 An issue which occurs in many areas of the world and in certain migrant/refugee communities is the strong stigma that is attached to the diagnosis of tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis-related stigma contributing to a ‘hidden’ disease at autopsy

Heath

Byard

2019

Med Sci Law

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A 29-year-old African immigrant to Australia was found dead in bed. She had no known medical history, except for recent weight loss and hip/leg pain. Autopsy examination revealed extensive tuberculous consolidation with widespread cavitation of the lungs, with multiple caseating granulomas containing large numbers of acid fast bacilli on histology. Similar granulomas were also present in lymph nodes of the porta hepatis, mediastinum and pulmonary hilum, and within the liver, spleen and mesentery. Mycobacterial polymerase chain reaction analysis confirmed tuberculous infection. Her serum was negative for human immunodeficiency virus infection. Death was due to disseminated tuberculosis. In many parts of Africa, there are negative cultural associations attached to tuberculosis, which often leads to a delay in diagnosis. The case demonstrates the extent of active disease that may be uncovered at autopsy in decedents from societies where tuberculosis is stigmatised and therefore concealed. It also emphasises the risk of infection for forensic workers.

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“…11 If the se ae ro sols con ta in ba cil li, they can ea sily in fect he alth wor kers. 12 TST de ter mi nes de la yed type hyper sen si ti vity re ac ti ons to so me an ti ge nic com po nents of mic roor ga nism. 13,14 The only sign of LTBI is po si ti ve TST.…”

Section: ö öZ Ze Et T Amentioning

confidence: 99%

“…12 TB ra te was de ter mi ned as 3.0% in anot her study from Tur key. 32 The se fin dings suggest that only half of the ca ses can be di ag no sed, and un di ag no sed ca ses live in the com mu nity unaware of their disease and they may constitute a risk for contamination of he althy pe op le.…”

mentioning

confidence: 99%

The Results of Tuberculin Skin Test and the Risk of Tuberculosis in Autopsy Workers

Özsoy¹,

Akar²,

Gümüş³

et al. 2010

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Tuberculosis (TB) is a disease that arises due to M. tuberculosis complex and usually involves the lungs but can also affect other organs or organ systems. The number of people who died in Turkey was 210146 in 2006 and 0.11% (n=249) of them died because of pulmonary tuberculosis. During autopsy, many microparticles (aerosols) can be generated while taking the organ out of the body, washing the body, or using the oscillating saw. If these aerosols may contain bacilli that can easily infect the health workers. Tuberculin skin test (TST) determines delayed type hypersensitivity reactions to some antigenic components of microorganism. The only sign of latent tuberculosis infection is positive TST. In our study, we aimed to calculate the exposure rate of the autopsy workers to TB bacillus by evaluating TST measurements and chest radiograms. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The study group was composed of 25 physicians and five autopsy technicians. The control group was composed of 30 physicians, residents and specialists of basic medical sciences except of Microbiology. Both groups were evaluated by TST and chest X-rays from TB point of view. We used TST reaction evaluation criteria that was suggested by Ministry of Health of Republic of Turkey while evaluating TST measurements. All measurements were analyzed statistically. R Re es su ul lt ts s: : TST positivity ratio is determined as 83.3% in the study group and 33.3% in the control group. The mean of TST measurement value is determined as 13.8±4.7 mm in the study group and 8.6±2.2 mm in the control group. There were no statistically significant differences between two groups concerning age, height, marital status, occupational experience or smoking habits (p>0.05). There was a statistically significant difference between study and control groups for the TST values were (F=11.786; p=0.001). There were no statistically significant differences for gender, smoking and interaction between gender-group and smoking-group (p>0.05). Established ANOVA model (univariate ANOVA); explained the =0.903 of TST change and it was statistically significant (F=71.159; p<0.001). There was a statistically significant correlation between TST results and time spent in the autopsy room (r=0.553; p=0.002). C Co on nc cl lu us si io on n: : Our study shows that autopsy workers have a high risk of TB exposure. We suggest that autopsy workers should be examined for occupational TB exposure. Furthermore, morgue buildings and autopsy rooms of our country should be designed in accordance with the international standards, and measures should be taken in this regard without delay.K Ke ey y W Wo or rd ds s: : Autopsy; tuberculosis; skin tests Ö ÖZ ZE ET T A Am ma aç ç: : Tüberküloz (TB), M. tuberculosis kompleks'in neden olduğu başlıca akciğerleri tutan, ancak akciğer dışı organ ya da sistemleri de tutabilen bir hastalıktır. Türkiye'de 2006'da 210146 ölüm olayı meydana gelmiş olup bunların %0.11'i (n=249) TB nedeniy...

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Tuberculosis Prevalence in Forensic Autopsies

Abstract: For this reason, we think that autopsy workers have to be careful about tuberculosis during their autopsy working.

Cited by 21 publications

References 8 publications

Pulmonary tuberculosis in a cohort of forensic autopsies: a preliminary study from Saudi Arabia

Pulmonary tuberculosis in a cohort of forensic autopsies: a preliminary study from Saudi Arabia

Tuberculosis-related stigma contributing to a ‘hidden’ disease at autopsy

The Results of Tuberculin Skin Test and the Risk of Tuberculosis in Autopsy Workers

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