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Epidemiology and factors associated with Extra-pulmonary tuberculosis in a Low-prevalence area
Open accessAbstract
Background: Tuberculosis is a global public health problem. Extra-pulmonary tuberculosis accounts for an increasing proportion of cases worldwide, although information about epidemiological, clinical, or microbiological factors is lacking. Methods: We conducted a retrospective observational study of tuberculosis cases diagnosed between 2016 and 2021, classified into Pulmonary and Extra-pulmonary tuberculosis. Univariable and multivariable logistic regression models were used to investigate risk factors of Extra-pulmonary tuberculosis. Results: 20.9% of overall cases were classified as Extra-pulmonary tuberculosis, with a rising trend from 22.6% in 2016 to 27.9% in 2021. Lymphatic tuberculosis accounted for 50.6% of cases, followed by pleural tuberculosis (24.1%). 55.4% of cases belonged to foreign-born patients. Microbiological culture tested positive in 92.8% of Extra-pulmonary cases. Logistic regression analysis showed that women were more predisposed to develop Extra-pulmonary tuberculosis (aOR 2.46, 95% CI 1.45-4.20) as well as elderly patients (aged ≥ 65 years) (aOR 2.47, 95% CI 1.19-5.13) and persons with previous history of tuberculosis (4.99, 95% CI 1.40-17.82). Conclusions: Extra-pulmonary Tuberculosis have increased within our study period. A profound decline occurred in 2021 tuberculosis cases, probably due to COVID-19. Women, elderly population, and persons with previous history of tuberculosis are at higher risk of developing Extra-pulmonary tuberculosis in our setting.
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“Our study found that 16.5% of all TB cases were epTB, which is lower to rates found in other developed countries like the Netherlands (38%), the United States (27%), and Germany (21.6%), as reported by Rolo et al.14.”
From Prevalence of extrapulmonary tuberculosis and factors influencing successful treatment outcomes among notified cases in South India (2025) · cites this paper as [14]
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Metadata
- Authors
- Rolo, M., González-Blanco, B., Reyes, C. A., Rosillo, N., & López-Roa, P.
- Affiliations
- Hospital Universitario 12 De Octubre (ES)
- Corresponding author
- López-Roa, P.
- Venue
- Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
- Publisher
- Elsevier BV
- Published
- 2023-08
- Volume
- 32
- Pages
- 100377
- ISSN
- 2405-5794 (ISSN-L)
- PMC
- PMC10209530
- OpenAlex
- W4376279658
- Cited by
- 85
- References
- 24
- Citations by year
- 2026: 22 · 2025: 30 · 2024: 31 · 2023: 1
- FWCI
- 17.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
- Locations
- Journal of Clinical Tuberculosis and Other Mycobacterial Diseases (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- European Commission
- Instituto de Salud Carlos III (PI21/01738)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Infectious Diseases › Diagnosis and treatment of tuberculosis
- Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
- Keywords
- extrapulmonary tuberculosis, pulmonary tuberculosis, tuberculous lymphadenitis, pleural tuberculosis, risk factors, sex differences, elderly patients, history of tuberculosis, foreign-born patients, tuberculosis incidence trends, low-prevalence areas
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
