Extrapulmonary tuberculosis in the setting of HIV hyperendemicity at a tertiary hospital in Durban, South Africa
| Autor: | S Gounden, R Perumal, Nombulelo P. Magula |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Tuberculosis signs and symptoms of extrapulmonary tb business.industry Extrapulmonary tuberculosis risk factors for extrapulmonary tb 030106 microbiology Human immunodeficiency virus (HIV) extrapulmonary tb hiv medicine.disease_cause medicine.disease Virology lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine parasitic diseases medicine lcsh:RC109-216 030212 general & internal medicine business |
| Zdroj: | Southern African Journal of Infectious Diseases, Vol 33, Iss 3, Pp 57-64 (2018) |
| ISSN: | 2313-1810 2312-0053 |
| Popis: | Background: South Africa has the highest burden of tuberculosis/human immunodeficiency virus (TB/HIV) co-infection in the world, with the province of KwaZulu-Natal representing the global epicentre of TB/HIV. While significant progress has been made to improve the diagnosis of pulmonary tuberculosis, the diagnosis of extrapulmonary TB (EPTB) remains a significant challenge in resource-constrained settings. Methods: A retrospective chart review was conducted, and included all adult patients diagnosed with EPTB at a tertiary hospital in Durban, South Africa, between January 1, 2016 and March 31, 2016.Results: There were 188 new cases of TB during the study period, with 80 patients diagnosed with EPTB. The mean age of patients was 34.73 (SD ± 9.44) years. Forty-two (52.5%) patients were female, while 76 (96%) were black. The most common risk factor for EPTB was HIV co-infection (88.8%). The median CD4 cell count was 68 (IQR 32–165) cells/mm3. Pleural (36.3%), lymph node (28.7%) and abdominal (27.5%) involvement were the most common sites of disease Weight loss, fever, night sweats and cough were amongst the most common symptoms reported. A microbiologically confirmed diagnosis was made in only 65% of cases. In the majority of cases, more than one diagnostic method was used to confirm the presence of TB in distant organs.Conclusion: Immunosuppression, most commonly by HIV, remains the most significant risk factor for the development of EPTB. Advancements in Xpert MTB/Rif and computed tomography have assisted in increasing the diagnostic armamentarium of EPTB. Despite improved access to antiretroviral therapy over the past years, advanced HIV disease remains a significant challenge to TB control. |
| Databáze: | OpenAIRE |
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