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Free Content Epidemiology of extra-pulmonary tuberculosis in Israel, 1999–2010

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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.
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Keywords: migration; screening; surveillance

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: 2013-02-01

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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.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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