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Occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the Frankfurt TB cohort 2013–2018
INTRODUCTION: Tuberculosis (TB) is caused by M. tuberculosis complex (MTB) and pulmonary tuberculosis (PTB) is its classical manifestation. However, in some regions of the world, extrapulmonary TB (EPTB) seems to be more frequent. METHODS: We performed a retrospective cohort study of all TB patients...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205846/ https://www.ncbi.nlm.nih.gov/pubmed/36181634 http://dx.doi.org/10.1007/s15010-022-01921-9 |
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author | Wetzstein, Nils Drummer, Alena-Pauline Bockey, Annabelle Herrmann, Eva Küpper-Tetzel, Claus Philippe Graf, Christiana Koch, Benjamin Goetsch, Udo Vehreschild, Maria J. G. T. Guglielmetti, Lorenzo Lange, Berit Wichelhaus, Thomas A. Stephan, Christoph |
author_facet | Wetzstein, Nils Drummer, Alena-Pauline Bockey, Annabelle Herrmann, Eva Küpper-Tetzel, Claus Philippe Graf, Christiana Koch, Benjamin Goetsch, Udo Vehreschild, Maria J. G. T. Guglielmetti, Lorenzo Lange, Berit Wichelhaus, Thomas A. Stephan, Christoph |
author_sort | Wetzstein, Nils |
collection | PubMed |
description | INTRODUCTION: Tuberculosis (TB) is caused by M. tuberculosis complex (MTB) and pulmonary tuberculosis (PTB) is its classical manifestation. However, in some regions of the world, extrapulmonary TB (EPTB) seems to be more frequent. METHODS: We performed a retrospective cohort study of all TB patients treated at University Hospital Frankfurt, Germany, for the time period 2013–2018. Patient charts were reviewed and demographic, clinical, and microbiological data recorded. Patients were subdivided according to their geographic origins. RESULTS: Of the 378 included patients, 309 were born outside Germany (81.7%). Three WHO regions were significantly associated with the occurrence of isolated EPTB: the South-East Asian Region (OR 3.37, CI 1.74–6.66, p < 0.001), the African Region (2.20, CI 1.25–3.90, p = 0.006), and the Eastern Mediterranean Region (OR 3.18, CI 1.78–5.76, p < 0.001). On a country level, seven countries of origin could be demonstrated to be significantly associated with the occurrence of isolated EPTB: India (OR 5.58, CI 2.30–14.20, p < 0.001), Nepal (OR 12.75, CI 1.73–259.28, p = 0.027), Afghanistan (OR 3.64, CI 1.14–11.98, p = 0.029), Pakistan (OR 3.64, CI 1.14–11.98, p = 0.029), Eritrea (OR 3.32, CI 1.52–7.47, p = 0.003), Somalia (OR 7.08, CI 2.77–19.43, p < 0.001), and Turkey (OR 9.56, CI 2.52–47.19, p = 0.002). CONCLUSION: Geographical origin is a predictor for the occurrence of extrapulmonary TB. This might be linked to a delay in diagnosis in these patients, as well as specific responsible impairments of the host’s immune system, possible virulence factors of MTB, and relevant comorbidities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s15010-022-01921-9. |
format | Online Article Text |
id | pubmed-10205846 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-102058462023-05-25 Occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the Frankfurt TB cohort 2013–2018 Wetzstein, Nils Drummer, Alena-Pauline Bockey, Annabelle Herrmann, Eva Küpper-Tetzel, Claus Philippe Graf, Christiana Koch, Benjamin Goetsch, Udo Vehreschild, Maria J. G. T. Guglielmetti, Lorenzo Lange, Berit Wichelhaus, Thomas A. Stephan, Christoph Infection Original Paper INTRODUCTION: Tuberculosis (TB) is caused by M. tuberculosis complex (MTB) and pulmonary tuberculosis (PTB) is its classical manifestation. However, in some regions of the world, extrapulmonary TB (EPTB) seems to be more frequent. METHODS: We performed a retrospective cohort study of all TB patients treated at University Hospital Frankfurt, Germany, for the time period 2013–2018. Patient charts were reviewed and demographic, clinical, and microbiological data recorded. Patients were subdivided according to their geographic origins. RESULTS: Of the 378 included patients, 309 were born outside Germany (81.7%). Three WHO regions were significantly associated with the occurrence of isolated EPTB: the South-East Asian Region (OR 3.37, CI 1.74–6.66, p < 0.001), the African Region (2.20, CI 1.25–3.90, p = 0.006), and the Eastern Mediterranean Region (OR 3.18, CI 1.78–5.76, p < 0.001). On a country level, seven countries of origin could be demonstrated to be significantly associated with the occurrence of isolated EPTB: India (OR 5.58, CI 2.30–14.20, p < 0.001), Nepal (OR 12.75, CI 1.73–259.28, p = 0.027), Afghanistan (OR 3.64, CI 1.14–11.98, p = 0.029), Pakistan (OR 3.64, CI 1.14–11.98, p = 0.029), Eritrea (OR 3.32, CI 1.52–7.47, p = 0.003), Somalia (OR 7.08, CI 2.77–19.43, p < 0.001), and Turkey (OR 9.56, CI 2.52–47.19, p = 0.002). CONCLUSION: Geographical origin is a predictor for the occurrence of extrapulmonary TB. This might be linked to a delay in diagnosis in these patients, as well as specific responsible impairments of the host’s immune system, possible virulence factors of MTB, and relevant comorbidities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s15010-022-01921-9. Springer Berlin Heidelberg 2022-10-01 2023 /pmc/articles/PMC10205846/ /pubmed/36181634 http://dx.doi.org/10.1007/s15010-022-01921-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Paper Wetzstein, Nils Drummer, Alena-Pauline Bockey, Annabelle Herrmann, Eva Küpper-Tetzel, Claus Philippe Graf, Christiana Koch, Benjamin Goetsch, Udo Vehreschild, Maria J. G. T. Guglielmetti, Lorenzo Lange, Berit Wichelhaus, Thomas A. Stephan, Christoph Occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the Frankfurt TB cohort 2013–2018 |
title | Occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the Frankfurt TB cohort 2013–2018 |
title_full | Occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the Frankfurt TB cohort 2013–2018 |
title_fullStr | Occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the Frankfurt TB cohort 2013–2018 |
title_full_unstemmed | Occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the Frankfurt TB cohort 2013–2018 |
title_short | Occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the Frankfurt TB cohort 2013–2018 |
title_sort | occurrence of extrapulmonary tuberculosis is associated with geographical origin: spatial characteristics of the frankfurt tb cohort 2013–2018 |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205846/ https://www.ncbi.nlm.nih.gov/pubmed/36181634 http://dx.doi.org/10.1007/s15010-022-01921-9 |
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