Extrapulmonary tuberculosis in the setting of HIV hyperendemicity at a tertiary hospital in Durban, South Africa
Southern African Journal of Infectious Diseases
| Field | Value | |
| Title | Extrapulmonary tuberculosis in the setting of HIV hyperendemicity at a tertiary hospital in Durban, South Africa | |
| Creator | Gounden, S. Perumal, R. Magula, N. P. | |
| Description | 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. | |
| Publisher | AOSIS Publishing | |
| Date | 2018-09-30 | |
| Identifier | 10.4102/sajid.v33i3.15 | |
| Source | Southern African Journal of Infectious Diseases; Vol 33, No 3 (2018); 57-64 2313-1810 2312-0053 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajid.co.za/index.php/sajid/article/view/15/11
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