Pulmonary and extrapulmonary tuberculosis at AIDS diagnosis in Spain

Castilla, Jesús; Gutiérrez, A; Guerra, Luis; Paz, J Pérez de la; Noguer, Isabel; Ruiz, Carlos Alberto Perea; Belza, María-José; Cañón, J

doi:10.1097/00002030-199713000-00006

Cited by 26 publications

(16 citation statements)

References 23 publications

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“…It is possible that extrapulmonary involvement is underdiagnosed in Brazil, since in the Basic Health Units the priority for tuberculosis diagnosis is examination of sputum smears [12]. A significant association between extrapulmonary involvement and the presence of risk factors was observed, as all patients, except for one, were co-infected by HIV, similar to what has been found in other studies [13,20]. There was a predominance of peripheral tuberculosis lymphadenitis in comparison to each of the other extrapulmonary forms, which was also found in other countries [18,20].…”

Section: Risk Factors* Discussionsupporting

confidence: 76%

“…In our study, 38.7% of the patients presented risk factors, the most frequent being HIV infection, alcoholism and injected drug use, respectively. Patients with risk factors were significantly younger than those without them, which may imply a relation of tuberculosis with the lifestyles among young adults today [13]. In Brazil, Monti identified alcoholism as the second-most-frequent risk factor, preceded only by co-morbidity with HIV [14].…”

Section: Risk Factors* Discussionmentioning

confidence: 99%

“…In Brazil, Monti identified alcoholism as the second-most-frequent risk factor, preceded only by co-morbidity with HIV [14]. There is concern about the growing prevalence of tuberculosis among injected drug users and among convicts in prisons in Brazil and other countries, this sometimes associated being with co-morbidity due to HIV [13,14]. Among the isolates from the patients, a frequency of 99.1% of M. tuberculosis was observed, an observation that validates the use of the initial treatment scheme for tuberculosis recommended by the Surgeon General of Brazil [15].…”

Section: Risk Factors* Discussionmentioning

confidence: 99%

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Tuberculosis: a study of 111 cases in an area of high prevalence in the extreme south of Brazil

Mattos¹,

Ribeiro²,

Netto³

et al. 2006

Braz J Infect Dis

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Tuberculosis is an increasingly important public health problem in developing countries. We studied 111 tuberculosis patients confirmed by mycobacteria isolation between 1998 and 2000 in Rio Grande, in south Brazil. One-hundred-thirteen pulmonary and extrapulmonary clinical materials were examined through culture by the Ogawa-Kudoh method and through smear examination by the Ziehl-Nielsen or Kinyoun methods. The identification of Mycobacterium tuberculosis was done through the usual phenotypical methods. The proportion method (indirect technique) was used to determine the resistance of isolates. The man/woman ratio was 2.6:1, 75% were white, and the group had a mean age of 39.7±12.7. Risk factors were present in 38.7% (34 men and 9 women, p=0.2), with a mean age of 35 (p=0.002); infection by HIV was the most frequent (28.8%), followed by alcoholism (16.2%) and injected drug use (15.3%). The frequency of M. tuberculosis isolates was 99.1%. Pulmonary disease occurred in 88.3% of the cases, extrapulmonary in 9.9% and 1.8% in both. There was an association between extrapulmonary tuberculosis and the presence of risk factors (p=0.0001). Resistance to isoniazid was found in 4% of the isolates and to isoniazid and rifampin in 2%, all being patients with some risk factors. The profile of tuberculosis in the population of this study followed the pattern described for developing regions of the world.

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Section: Risk Factors* Discussionsupporting

confidence: 76%

Section: Risk Factors* Discussionmentioning

confidence: 99%

Section: Risk Factors* Discussionmentioning

confidence: 99%

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Tuberculosis: a study of 111 cases in an area of high prevalence in the extreme south of Brazil

Mattos¹,

Ribeiro²,

Netto³

et al. 2006

Braz J Infect Dis

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“…It is well known that the probability of TB-HIV co-infection increases in line with CD4 lymphocyte counts [6]. Our preliminary (crude) results agree with this medical ÿnding, since the median of CD4 counts was found to be signiÿcantly higher in patients diagnosed with AIDS via TB (median = 152) than in those diagnosed with AIDS via other illness (median = 63).…”

Section: Introductionsupporting

confidence: 89%

Non‐parametric estimation of the odds ratios for continuous exposures using generalized additive models with an unknown link function

Cadarso‐Suárez

Roca‐Pardiñas

Figueiras

et al. 2004

Statistics in Medicine

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The generalized additive, model (GAM) is a powerful and widely used tool that allows researchers to fit, non-parametrically, the effect of continuous predictors on a transformation of the mean response variable. Such a transformation is given by a so-called link function, and in GAMs this link function is assumed to be known. Nevertheless, if an incorrect choice is made for the link, the resulting GAM is misspecified and the results obtained may be misleading. In this paper, we propose a modified version of the local scoring algorithm that allows for the non-parametric estimation of the link function, by using local linear kernel smoothers. To better understand the effect that each covariate produces on the outcome, results are expressed in terms of the non-parametric odds ratio (OR) curves. Bootstrap techniques were used to correct the bias in the OR estimation and to construct point-wise confidence intervals. A simulation study was carried out to assess the behaviour of the resulting estimates. The proposed methodology was illustrated using data from the AIDS Register of Galicia (NW Spain), with a view to assessing the effect of the CD4 lymphocyte count on the probability of being AIDS-diagnosed via Tuberculosis (TB). This application shows how the link's flexibility makes it possible to obtain OR curve estimates that are less sensitive to the presence of outliers and unusual values that are often present in the extremes of the covariate distributions.

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“…HIV infection is a well-known risk factor for reactivation of latent tuberculosis, because of altered cellular immune function whatever the level of CD4 count [23]. When immune suppression is advanced EPTB dissemination becomes more frequent [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic factors that contribute to the development of extrapulmonary tuberculosis were identified

Cailhol

Decludt

Che

2005

Journal of Clinical Epidemiology

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Pulmonary and extrapulmonary tuberculosis at AIDS diagnosis in Spain

Abstract: The results suggest the importance that recent transmission of TB may be having among young adults, IDU and prison inmates in particular, and calls for a review of control strategies.

Cited by 26 publications

References 23 publications

Tuberculosis: a study of 111 cases in an area of high prevalence in the extreme south of Brazil

Tuberculosis: a study of 111 cases in an area of high prevalence in the extreme south of Brazil

Non‐parametric estimation of the odds ratios for continuous exposures using generalized additive models with an unknown link function

Sociodemographic factors that contribute to the development of extrapulmonary tuberculosis were identified

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