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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
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