Epidemiology of extra-pulmonary tuberculosis in Israel, 1999–2010
Abstract:SETTING: The Israeli national tuberculosis (TB) surveillance system.
OBJECTIVES: To describe the epidemiology of extra-pulmonary tuberculosis (EPTB) in Israel between 1999 and 2010 and identify more susceptible populations.
DESIGN: Data were retrieved from the National Tuberculosis Registry and the Israeli Bureau of Statistics.
RESULTS: During the study period, 995 EPTB patients were notified, corresponding to 19.6% of all TB cases. The average annual male:female ratio was 0.8, and the human immunodeficiency virus (HIV) infection rate was 5%. Most EPTB affected the lymph nodes (39.8%), pleura (16.9%) and urinary system (11.1%). Most EPTB patients (81.8%) were non-Israeli born. The estimated average annual incidence in Israeli-born citizens, non-Israeli-born citizens and migrant workers was respectively 0.23, 2.2 and 7.5 per 100 000 population. The ratio of non-Israeli-born migrant workers to non-Israeli-born citizens with EPTB decreased from 1:6.3 in 1999 to 1:0.78 in 2010. Culture results were obtained for 624 (62.9%) of all cases. Of these, 41 (6.6%) were resistant to at least one first-line anti-tuberculosis drug and 8 (1.3%) were multidrug-resistant. Treatment success was achieved in 86.5%.
CONCLUSIONS: Physicians should be aware of the possibility of EPTB in older patients, especially in the non-Israeli-born. Innovative screening procedures should be implemented for migrants from high-burden countries.
Document Type: Research Article
Affiliations: 1: Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel; Ramla Department of Health, Ramla, Israel 2: Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel 3: Tel Aviv Tuberculosis Clinic, League Against Tuberculosis and Lung Diseases, Tel Aviv, Israel 4: Public Health Services, Jerusalem, Israel; and Faculty of Medicine, Ben Gurion University in the Negev, Beer Sheva, Israel
Publication date: February 1, 2013
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