Spinal tuberculosis among human immunodeficiency virus–negative patients in a Kenyan tertiary hospital: a 5-year synopsis

Mwachaka, Philip Maseghe; Ranketi, Simeon; Obonyo, Nchafatso G.; Kasyoka, Ben M.; Kiboi, Julius G.

doi:10.1016/j.spinee.2011.01.033

Cited by 17 publications

(13 citation statements)

References 19 publications

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“…In the current study, 50% of all spinal TB cases were between 23 and 47 years old with a median age of 38 years among adult cases (Table 1). While previous studies from the USA [4] and Eastern Mediterranean [11] reported a somewhat older median age of approximately 50 years among spinal TB cases, the current age distribution is similar to findings from Kenya [24] and China (27) 110 (28) Data are presented as n (%) for non-missing data, unless otherwise indicated, with % values rounded to the nearest whole number. a MRI, magnetic resonance imaging (n = 378); CT, computed tomography (n = 4).…”

Section: Spinal Tb Among Adults In the Western Capesupporting

confidence: 72%

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

et al. 2018

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The aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6–4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases.

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Section: Spinal Tb Among Adults In the Western Capesupporting

confidence: 72%

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

et al. 2018

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“…Early initiation of an appropriate treatment regimen may reduce the need for surgical intervention. [24] Mwachaka et al [26] noted that patients with STB in their setting tended to present late and with advanced disease. Therefore, a high index of suspicion should be maintained and appropriate chemotherapy started as early as possible.…”

Section: Discussionmentioning

confidence: 99%

Early predictive factors for lower-extremity motor or sensory deficits and surgical results of patients with spinal tuberculosis

et al. 2016

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Many studies about the characteristics of spinal tuberculosis (STB) have been published, but none has investigated the predictive factors for lower-extremity motor or sensory deficits (LMSD) in patients with STB.The objective of this study was to find early predictive factors for LMSD and evaluate surgical results of patients with STB.From 2001 through 2010, 329 patients with STB were treated in our department and surgical treatment was performed in 274 patients. The factors assessed included age, sex, duration of symptoms, worsening of illness, clinical symptoms, clinical signs, imaging characteristics, kyphotic angle, Oswestry disability index (ODI), and visual analogue scale (VAS) scores.Of the 329 patients studied, 164 presented with LMSD (the LMSD group), of which 93 patients (28.3%) had motor deficits and 177 patients (53.8%) had sensory disturbance. The other 165 patients were included in the control group (the No LMSD group). Using univariate logistic regression analysis, we found that the sex (P = 0.042), age (P = 0.001), worsening of sickness (P = 0.013), location (P = 0.009), and spinal compression (P = 0.035) were the risk factors of LMSD. Furthermore, the multivariate logistic regression analysis indicated that age (OR = 1.761, 95% CI: 1.227–2.526, P = 0.002), worsening of sickness (yes vs no: OR = 1.910, 95% CI: 1.161–3.141, P = 0.011), location (T vs C: OR = 0.204, 95% CI: 0.063–0.662, P = 0.008), and spinal compression (yes vs no: OR = 1.672, 95% CI: 1.020–2.741, P = 0.042) were independent risk factors of LMSD. Surgical treatment was performed in 274 patients. The kyphotic angle improved from 25.8 ± 9.1° preoperatively to 14.0 ± 7.6°, with a mean correction of 11.8 ± 4.0°, and a mean correction loss of 1.5 ± 1.8° at final visit. There were significant differences between the preoperative and the final ODI and VAS scores in both groups (P < 0.001 and P < 0.001, respectively).Spinal tuberculosis with cervical or lumbar vertebra involvement among the elder patients with a history of worsening of illness and spinal compression tended to cause LMSD, such as motor deficits or sensory disturbance. We should implement an appropriate treatment regimen to prevent exacerbation of STB such as operation, which can achieve thoroughness of debridement, adequate spinal stabilization, and better functional recovery.

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“…First, all of the chemotherapy regimens for pulmonary tuberculosis are appropriate for extrapulmonary tuberculosis. The effects of short-course chemotherapy in extrapulmonary tuberculosis are similar to those in pulmonary tuberculosis [20][21][22]; spinal tuberculosis is a common type of extrapulmonary tuberculosis; therefore, the ultra short-course chemotherapy should have the same effects. Second, the density of Mycobacterium tuberculosis organisms in lesions of spinal tuberculosis is less than the density in lesions of pulmonary tuberculosis [23].…”

Section: Discussionmentioning

confidence: 99%

Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation

et al. 2012

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Spinal tuberculosis among human immunodeficiency virus–negative patients in a Kenyan tertiary hospital: a 5-year synopsis

Cited by 17 publications

References 19 publications

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

Early predictive factors for lower-extremity motor or sensory deficits and surgical results of patients with spinal tuberculosis

Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation

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