Insight to the Epidemiology and Risk Factors of Extrapulmonary Tuberculosis in Tianjin, China during 2006-2011

Abstract

BackgroundThe proportion of extrapulmonary tuberculosis (EPTB) among all the reported tuberculosis (TB) cases has increased in different populations. Despite the large burden of TB in China, the epidemiology of EPTB in China remains largely understudied and the risk factors for having EPTB diagnosis in China have not been identified.MethodsTo gain insight to EPTB epidemiology in China, we analyzed TB surveillance data collected in Tianjin, China, during 2006 to 2011. The frequency of EPTB among all TB cases and within different socio-demographic groups of the study patients aged 15 years and older was determined for EPTB in general and by specific types. The distribution of socio-demographic characteristics was compared between pulmonary TB (PTB) group and EPTB group by chi-square test. Crude and multiple logistic regression-derived adjusted odds ratios (aOR) and 95% confidence intervals (CI) were determined to assess the associations between having EPTB diagnosis and each individual explanatory variable in question.ResultsAbout one-tenth (1,512/14,561) of the patients investigated in this study had EPTB. Of these 1,512 EPTB cases, about two thirds were pleural TB. Significant difference in age, occupation, and urbanity of residence were found between PTB and EPTB groups (p<0.05). Patients with EPTB diagnosis were more likely to be 65 years or older (aOR = 1.22, 95% CI: 1.02, 1.46), to be retired (aOR = 1.37, 95% CI: 1.08, 1.75), and to live in urban areas (aOR = 1 38, 95% CI: 1.22, 1.55).ConclusionsThe findings of this study extends the knowledgebase of EPTB epidemiology in developing countries and highlight the need for improved EPTB detection in China, especially in subpopulations with high risk for EPTB or having limited access to medical facilities with adequate capacity for EPTB diagnosis.

Risk Factors for Extra Pulmonary Tuberculosis in the Health District of Thies, Senegal

“…In Europe, same results were observed in Denmark [26] and in Croatia [7]. In the USA, unemployment was associated with EPTB [12,16]. This is the case too in China [27] and Japan too [28].…”

“…In another view, sometimes, treatment is proposed empirically based on clinical and radiological arguments. Studies conducted worldwide have identified several risk factors associated with the occurrence of EPTB: age [1,2,9], female sex [1,11,12], no vaccination [13], contact with TB patient [5,12,14], alcohol consumption [11,15], employment [13,16], diabetes [15] and HIV infection [1,11] particularly. Senegal, like many Sub-Saharan African countries, is facing the TB epidemics.…”

Tuberculosis in a Portuguese Cohort

“…Existing studies on the prevalence of ETB are quite contrasting and usually reflect local and regional differences, being difficult to reach any conclusions. [13][14][15][16][17][18][65][66][67][68] Even so, in some studies, lymphatic TB stands out as the most common form of ETB. [52][53][54] Some forms of TB were less frequent in our study than expected.…”

“…1,8,[11][12] The proportion of patients with extrapulmonary (ETB) or pulmonary TB (PTB) varies along different world regions. [13][14][15][16][17][18] ETB is more frequent in people with a compromised immune system, as is the case in HIV-infected patients. 11,12 Some patients have characteristics that put them at risk of acquiring TB.…”

A Clinic-Epidemiological Study of Head and Neck Tuberculosis—A Single-Center Experience

“…Studies conducted in developed countries have revealed that, while the overall incidence of TB has been declining, the proportion of EPTB has increased [2,4]. Also Wang et al [8] in their comprehensive study from Tianjin, the fourth largest city in China with 13 million inhabitants, reported 10% EPTB between 2006 and 2011. Similar result, 13.3%, was noted in Taiwan by Lin and coworkers [9].…”