Recurrent Tuberculosis Disease in Singapore

Autor:	Yee Tang Wang, Suay Hong Gan, Cynthia B.E. Chee, Li Hwei Sng, Kyi Win KhinMar, Leo Kang Yang Lim, Li Wei Ang
Rok vydání:	2021
Předmět:	0301 basic medicine medicine.medical_specialty Tuberculosis exogenous reinfection 030106 microbiology Disease Logistic regression Major Articles 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine 030212 general & internal medicine relapse business.industry Extrapulmonary tuberculosis Odds ratio medicine.disease Confidence interval extrapulmonary Infectious Diseases AcademicSubjects/MED00290 Oncology tuberculosis Concomitant Sputum medicine.symptom business
Zdroj:	Open Forum Infectious Diseases
ISSN:	2328-8957
Popis:	Background Previously treated (ie, recurrent) tuberculosis (TB) cases account for approximately 7%–8% of incident TB globally and in Singapore. Molecular fingerprinting has enabled the differentiation of these patients into relapsed or reinfection cases. Methods Patient demographics, disease characteristics, and treatment information were obtained from the national TB notification registry and TB Control Unit. We performed a retrospective, case-control study to evaluate factors associated with recurrent TB disease in Singapore citizens and permanent residents with culture-positive TB from 2006 to 2013 and who developed a second episode of culture-positive TB up to 2016 using multivariable logistic regression analyses. Results Ninety-one cases with culture-positive first and recurrent TB disease episodes were identified. Recurrent TB was associated with age ≥60 years (adjusted odds ratio [aOR], 1.98 [95% confidence interval {CI}, 1.09–3.61), male sex (aOR, 2.29 [95% CI, 1.22–4.51]), having concomitant pulmonary and extrapulmonary TB (aOR, 3.10 [95% CI, 1.59–6.10]) and extrapulmonary TB alone (aOR, 3.82 [95% CI, 1.12–13.31]), and was less likely in non-Malays (aOR, 0.52 [95% CI, .27–.99]). DNA fingerprinting results for both episodes in 49 cases differentiated these into 28 relapsed and 21 reinfection cases. Relapse was associated with having concomitant pulmonary and extrapulmonary TB (aOR, 9.24 [95% CI, 2.50–42.42]) and positive sputum acid-fast bacilli smear (aOR, 3.95 [95% CI, 1.36–13.10]). Conclusions Relapse and reinfection contributed to 57% and 43%, respectively, of recurrent TB in Singapore. Our study highlights the underappreciated association of concomitant pulmonary and extrapulmonary TB as a significant risk factor for disease relapse. Relapse and reinfection contributed to 57% and 43%, respectively, of recurrent tuberculosis (TB) cases in Singapore, a densely populated country with intermediate TB incidence. Positive sputum smear and concomitant pulmonary and extrapulmonary TB disease were significantly associated with risk of relapse.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::24b70a8267074a4ede9be5f16df4dbe2 https://pubmed.ncbi.nlm.nih.gov/34307732 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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