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Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities

BACKGROUND: Extra-pulmonary tuberculosis (EPTB) represents about 14% of all cases of tuberculosis (TB) in Malaysia. The aims of the study include evaluation of socio-demographic factors, clinical manifestations, co-morbidities among patients with EPTB and their treatment outcomes. METHODS: A retrosp...

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Autores principales: Khan, Amer Hayat, Sulaiman, Syed Azhar Syed, Laghari, Madeeha, Hassali, Mohamed Azmi, Muttalif, Abdul Razak, Bhatti, Zohra, Ming, Long Chiau, Talpur, Bandeh Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683549/
https://www.ncbi.nlm.nih.gov/pubmed/31382889
http://dx.doi.org/10.1186/s12879-019-4312-9
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author Khan, Amer Hayat
Sulaiman, Syed Azhar Syed
Laghari, Madeeha
Hassali, Mohamed Azmi
Muttalif, Abdul Razak
Bhatti, Zohra
Ming, Long Chiau
Talpur, Bandeh Ali
author_facet Khan, Amer Hayat
Sulaiman, Syed Azhar Syed
Laghari, Madeeha
Hassali, Mohamed Azmi
Muttalif, Abdul Razak
Bhatti, Zohra
Ming, Long Chiau
Talpur, Bandeh Ali
author_sort Khan, Amer Hayat
collection PubMed
description BACKGROUND: Extra-pulmonary tuberculosis (EPTB) represents about 14% of all cases of tuberculosis (TB) in Malaysia. The aims of the study include evaluation of socio-demographic factors, clinical manifestations, co-morbidities among patients with EPTB and their treatment outcomes. METHODS: A retrospective study was conducted to recognize the epidemiology facts of EPTB. Individual data for EPTB patients were collected from TB registers, laboratory TB registers, treatment cards and TB medical personal files into a standardized study questionnaire. Crude (COR) and adjusted odds ratios (AOR) and 95% confidence intervals (CI) were determined to assess the risk factors for EPTB and unsuccessful treatment outcomes. RESULTS: There were 1222 EPTB patients presenting 13.1% of all TB cases during 2006–2008. Pleural effusion and lymph node TB were the most frequent types and accounted for 45.1% of all EPTB cases among study participants. Treatment success rate was 67.6%. The best treatment completion rates were found in children ≤15 years (0.478 [0.231–1.028]; p = 0.05). On multivariate analysis, age group 56–65 years (1.658 [1.157–2.376]; p = 0.006), relapse cases (7.078 [1.585–31.613]; p = 0.010), EPTB-DM (1.773 [1.165–2.698]; p = 0.008), patients with no formal (2.266 [1.254–4.095]; p = 0.001) and secondary level of education (1.889 [1.085–3.288]; p = 0.025) were recorded as statistically positive significant risk factors for unsuccessful treatment outcomes. Patients at the risk of EPTB were more likely to be females (1.524 [1.311–1.746]; p <  0.001), Malays (1.251 [1.056–1.482]; p = 0.010) and Indians (1.450 [1.142–1.842]; p = 0.002), TB-HIV (3.215 [2.347–4.405]; p <  0.001), EPDM-HIV (4.361 [1.657–11.474]; p = 0.003), EPTB-HIV-HEP (4.083 [2.785–5.987]; p <  0.001), those living in urban areas (1.272 [1.109–1.459]; p = 0.001) and no formal education (1.361 [1.018–1.820]; p = 0.037). CONCLUSION: The findings of this study extend the knowledge of EPTB epidemiology and highlight the need for improved EPTB detection in Malaysia, especially in subpopulations with high risk for EPTB and unsuccessful treatment outcomes.
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spelling pubmed-66835492019-08-09 Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities Khan, Amer Hayat Sulaiman, Syed Azhar Syed Laghari, Madeeha Hassali, Mohamed Azmi Muttalif, Abdul Razak Bhatti, Zohra Ming, Long Chiau Talpur, Bandeh Ali BMC Infect Dis Research Article BACKGROUND: Extra-pulmonary tuberculosis (EPTB) represents about 14% of all cases of tuberculosis (TB) in Malaysia. The aims of the study include evaluation of socio-demographic factors, clinical manifestations, co-morbidities among patients with EPTB and their treatment outcomes. METHODS: A retrospective study was conducted to recognize the epidemiology facts of EPTB. Individual data for EPTB patients were collected from TB registers, laboratory TB registers, treatment cards and TB medical personal files into a standardized study questionnaire. Crude (COR) and adjusted odds ratios (AOR) and 95% confidence intervals (CI) were determined to assess the risk factors for EPTB and unsuccessful treatment outcomes. RESULTS: There were 1222 EPTB patients presenting 13.1% of all TB cases during 2006–2008. Pleural effusion and lymph node TB were the most frequent types and accounted for 45.1% of all EPTB cases among study participants. Treatment success rate was 67.6%. The best treatment completion rates were found in children ≤15 years (0.478 [0.231–1.028]; p = 0.05). On multivariate analysis, age group 56–65 years (1.658 [1.157–2.376]; p = 0.006), relapse cases (7.078 [1.585–31.613]; p = 0.010), EPTB-DM (1.773 [1.165–2.698]; p = 0.008), patients with no formal (2.266 [1.254–4.095]; p = 0.001) and secondary level of education (1.889 [1.085–3.288]; p = 0.025) were recorded as statistically positive significant risk factors for unsuccessful treatment outcomes. Patients at the risk of EPTB were more likely to be females (1.524 [1.311–1.746]; p <  0.001), Malays (1.251 [1.056–1.482]; p = 0.010) and Indians (1.450 [1.142–1.842]; p = 0.002), TB-HIV (3.215 [2.347–4.405]; p <  0.001), EPDM-HIV (4.361 [1.657–11.474]; p = 0.003), EPTB-HIV-HEP (4.083 [2.785–5.987]; p <  0.001), those living in urban areas (1.272 [1.109–1.459]; p = 0.001) and no formal education (1.361 [1.018–1.820]; p = 0.037). CONCLUSION: The findings of this study extend the knowledge of EPTB epidemiology and highlight the need for improved EPTB detection in Malaysia, especially in subpopulations with high risk for EPTB and unsuccessful treatment outcomes. BioMed Central 2019-08-05 /pmc/articles/PMC6683549/ /pubmed/31382889 http://dx.doi.org/10.1186/s12879-019-4312-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Khan, Amer Hayat
Sulaiman, Syed Azhar Syed
Laghari, Madeeha
Hassali, Mohamed Azmi
Muttalif, Abdul Razak
Bhatti, Zohra
Ming, Long Chiau
Talpur, Bandeh Ali
Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities
title Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities
title_full Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities
title_fullStr Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities
title_full_unstemmed Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities
title_short Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities
title_sort treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683549/
https://www.ncbi.nlm.nih.gov/pubmed/31382889
http://dx.doi.org/10.1186/s12879-019-4312-9
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