Risk factors for extra-pulmonary tuberculosis compared to pulmonary tuberculosis

Authors: Lin, J.N.¹; Lai, C.H.¹; Chen, Y.H.²; Lee, S.S.J.³; Tsai, S.S.⁴; Huang, C.K.⁵; Chung, H.C.⁵; Liang, S.H.⁵; Lin, H.H.⁵

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 5, May 2009 , pp. 620-625(6)

Publisher: International Union Against Tuberculosis and Lung Disease

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The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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By this author: Lin, J.N. ; Lai, C.H. ; Chen, Y.H. ; Lee, S.S.J. ; Tsai, S.S. ; Huang, C.K. ; Chung, H.C. ; Liang, S.H. ; Lin, H.H.

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Abstract:

BACKGROUND: Tuberculosis (TB) continues to be a major global health problem. Extra-pulmonary TB (EPTB) manifests with protean symptoms, and establishing a diagnosis is more difficult than pulmonary TB (PTB).

SETTING: A university-affiliated hospital in southern Taiwan.

OBJECTIVE: To analyse the risk factors for EPTB compared with PTB.

DESIGN: This retrospective study compared patients with EPTB and PTB in southern Taiwan by analysing their demographic data and clinical underlying diseases. Risk factors for EPTB were further analysed.

RESULTS: A total of 766 TB patients were enrolled in this study, with 102 (13.3%) EPTB and 664 (86.7%) PTB cases. Of the 766 patients, 3% of PTB patients had EPTB, while 19.6% of EPTB patients also had PTB. The most frequently involved EPTB site was the bone and joints (24.5%). The incidence of EPTB vs. PTB decreased significantly for each decade increase in patient age. Multivariate logistic regression analysis showed that being female, not being diabetic, having end-stage renal disease and not smoking were independent risk factors for EPTB.

CONCLUSION: This study defines the risk factors for EPTB compared with PTB. Awareness of these factors is essential for physicians to have a high index of suspicion for accurate and timely diagnosis.

Keywords: Mycobacterium tuberculosis; tuberculosis; extra-pulmonary tuberculosis; risk factors

Document Type: Regular paper

Affiliations: 1: Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan 2: Graduate Institute of Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan 3: Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 4: Department of Healthcare Administration, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan 5: Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan