机构:[1]Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital MedicalUniversity, Beijing, China[2]Chongqing Public Health Medical Center, Chongqing, China[3]Shenyang chestHospital, Shenyang, China[4]Guang Zhou Chest Hospital, Guangzhou, Guangdong, China[5]ChestHospital of Xinjiang, Urumqi, Xinjiang, China[6]The Third People’s Hospital of Kunming, Kunming City,Yunnan Province, China[7]Shandong provincial Chest Hospital, Jinan, Shandong, China[8]Jiangxi Chest(third people) Hospital, Nanchang City, Jiangxi Province, China[9]Chang Chun Infectious Diseases Hospital,Changchun City, Jilin Province, China[10]Taiyuan Fourth People’s Hospital, Taiyuan City, Shanxi Province,China,[11]Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China[12]Tianjin Haihe Hospital, Tianjin City,China,[13]Third People’s Hospital of Shenzhen, Shenzhen, China[14]The First Affiliated Hospital ofChongqing Medical University, Chongqing, China重庆医科大学附属第一医院[15]Weifang NO.2 People’s Hospital, Shandong Province,China,[16]The Fifth People’s Hospital of Suzhou, Suzhou City, Jiangsu Province, China[17]AffiliatedHospital of Zunyi Medical College, Zunyi, Guizhou, China[18]The Fifth People’s Hospital of Wuxi, Wuxi,China,[19]TB Hospital of Siping City, Siping City, Jilin Province, China[20]Baoding Hospital for InfectiousDisease, Baoding City, Hebei Province, China[21]The First Affiliated of XiaMen University, Xiamen City,Fujian Province, China
Tuberculosis (TB) remains a serious global public health problem in the present. TB also affects other sites (extrapulmonary tuberculosis, EPTB), and accounts for a significant proportion of tuberculosis cases worldwide. In order to comprehensively understand epidemiology of EBTB in China, and improve early diagnosis and treatment, we conducted a large-scale multi-center observational study to assess the demographic data and the prevalence of common EPTB inpatients, and further evaluate the prevalence of EPTB concurrent with Pulmonary tuberculosis (PTB) and the associations between multiple EPTB types and gender-age group in China. All consecutive age≥15yr inpatients with a confirmed diagnosis of EPTB during the period from January 2011 to December 2017 were included in the study. The descriptive statistical analysis included median and quartile measurements for continuous variables, and frequencies and proportions with 95% confidence intervals (CIs) for categorical variables. Multinomial logistic regression analysis was used to compare the association of multiple EPTB types between age group and gender. The results showed that the proportion of 15-24 years and 25-34 years in EPTB inpatients were the most and the ratio of male: female was 1.51. Approximately 70% of EPTB inpatients were concurrent with PTB or other types of EPTB. The most common of EPTB was tuberculous pleurisy (50.15%), followed by bronchial tuberculosis (14.96%), tuberculous lymphadenitis of the neck (7.24%), tuberculous meningitis (7.23%), etc. It was found that many EPTB inpatients concurrent with PTB. The highest prevalence of EPTB concurrent with PTB was pharyngeal/laryngeal tuberculosis (91.31%), followed by bronchial tuberculosis (89.52%), tuberculosis of hilar lymph nodes (79.52%), tuberculosis of mediastinal lymph nodes (79.13%), intestinal tuberculosis (72.04%), tuberculous pleurisy (65.31%) and tuberculous meningitis (62.64%), etc. The results from EPTB concurrent with PTB suggested that females EPTB inpatients were less likely to be at higher risk of concurrent PTB (aOR = 0.819, 95%CI:0.803-0.835) after adjusted by age. As age increasing, the trend risk of concurrent PTB decreased (aOR = 0.994, 95%CI: 0.989-0.999) after adjusted by gender. Our study demonstrated that the common EPTB were tuberculous pleurisy, bronchial tuberculosis, tuberculous lymphadenitis of the neck, tuberculous meningitis, etc. A majority of patients with pharyngeal/laryngeal tuberculosis, bronchial tuberculosis, tuberculosis of hilar/mediastinal lymph nodes, intestinal tuberculosis, tuberculous pleurisy, tuberculous meningitis, etc. were concurrent with PTB. Female EPTB inpatients were less likely to be at higher risk of concurrent PTB, and as age increasing, the trend risk of concurrent PTB decreased. The clinicians should be alert to the presence of concurrent tuberculosis in EPTB, and all suspected cases of EPTB should be assessed for concomitant PTB to determine whether the case is infectious and to help for early diagnosis and treatment.
第一作者机构:[1]Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital MedicalUniversity, Beijing, China
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通讯作者:
推荐引用方式(GB/T 7714):
Kang Wanli,Yu Jiajia,Du Jian,et al.The epidemiology of extrapulmonary tuberculosis in China: A large-scale multi-center observational study.[J].PLOS ONE.2020,15(8):doi:10.1371/journal.pone.0237753.
APA:
Kang Wanli,Yu Jiajia,Du Jian,Yang Song,Chen Hongyan...&Tang Shenjie.(2020).The epidemiology of extrapulmonary tuberculosis in China: A large-scale multi-center observational study..PLOS ONE,15,(8)
MLA:
Kang Wanli,et al."The epidemiology of extrapulmonary tuberculosis in China: A large-scale multi-center observational study.".PLOS ONE 15..8(2020)