Abstract
BackgroundExtrapulmonary tuberculosis (EPTB) has an increasing rate in Turkey. The reason remains largely unknown. A better understanding of the demographic and microbial characteristics of EPTB in the Turkish population would extend the knowledgebase of EPTB and allow us to develop better strategies to control tuberculosis (TB).MethodsWe retrospectively evaluated clinical and laboratory data of 397 bacteriologically-confirmed TB cases diagnosed during an eight year-period using by chi-square analysis and multivariate logistic regression model.ResultsOf the 397 study patients, 103 (25.9%) had EPTB and 294 (74.1%) had pulmonary tuberculosis (PTB). The most commonly seen two types of EPTB were genitourinary TB (27.2%) and meningeal TB (19.4%). TB in bone/joints, pleural cavity, lymph nodes, skin, and peritoneal cavity occurred at a frequency ranging from 9.7% to 10.7%. The age distribution was significantly different (P < 0.01) between PTB and EPTB, with patients older than 45 years tending to have an increased risk of EPTB. Furthermore, the distribution of different types of EPTB differed significantly among age groups (P = 0.03). Meningeal and bone and/or joint TB were more commonly observed among the male patients, while lymphatic, genitourinary, and peritoneal TB cases were more frequently seen among females. Unique strain infection was statistically significantly associated with EPTB (OR: 2.82, 95% CI [1.59, 5.00])ConclusionsEPTB accounted for a significant proportion of TB cases in Malatya, Turkey between 2001 and 2007. The current study has provided an insight into the dynamics of EPTB in Malatya, Turkey. However, the risk factors for having EPTB in Malatya, Turkey remain to be assessed in future studies using population-based or randomly selected sample.
Highlights
Extrapulmonary tuberculosis (EPTB) has an increasing rate in Turkey
Different from previous studies of EPTB, in our study, being female was not found to be a risk factor for EPTB. It was not statistically significant, meningeal and bone and/or joint TB were more commonly observed among the male patients than among the female patients
We found that age distribution was significantly different (P < 0.01) between pulmonary TB (PTB) and EPTB
Summary
Extrapulmonary tuberculosis (EPTB) has an increasing rate in Turkey. One third of the world’s population is latently infected with Mycobacterium tuberculosis [1], of which about 10% may develop active disease at anytime [2]. The infection of M. tuberculosis usually results in pulmonary TB, other organs and tissues can be affected, resulting in extrapulmonary or disseminated TB [3,4,5]. Extrapulmonary TB (EPTB) is a significant health problem, as is pulmonary TB (PTB), in both developing. Turkey is a developing country with a population of more than 70 million and about 20,000 notified new TB cases annually. The reason for such an increase remains largely unknown. TB control is mainly done by dispensaries around the country, sanatorium hospitals, and university hospitals.
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