The prevalence, risk factors, and public health consequences of peripheral lymph node–associated clinical and subclinical pulmonary tuberculosis
Objectives: Relatively little is known about the prevalence, risk factors, and public health consequences of peripheral lymph node (PLN)–associated pulmonary tuberculosis (PTB). Methods: We developed a 10-year (2010-2019) population-based cohort of PLNTB patients in Canada. We used systematically co...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971223000267 |
| _version_ | 1797868287417122816 |
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| author | Courtney Heffernan Mary Lou Egedahl James Barrie Christopher Winter Gavin Armstrong Alexander Doroshenko Gregory Tyrrell Catherine Paulsen Angela Lau Richard Long |
| author_facet | Courtney Heffernan Mary Lou Egedahl James Barrie Christopher Winter Gavin Armstrong Alexander Doroshenko Gregory Tyrrell Catherine Paulsen Angela Lau Richard Long |
| author_sort | Courtney Heffernan |
| collection | DOAJ |
| description | Objectives: Relatively little is known about the prevalence, risk factors, and public health consequences of peripheral lymph node (PLN)–associated pulmonary tuberculosis (PTB). Methods: We developed a 10-year (2010-2019) population-based cohort of PLNTB patients in Canada. We used systematically collected primary source data and expert reader chest radiograph interpretations in a multivariable logistic regression to determine associations between sputum culture positivity and demographic, clinical, and radiographic features. Public health risks were estimated among contacts of PLNTB patients. Results: There were 306 patients with PLNTB, among whom 283 (92.5%) were 15-64 years of age, 159 (52.0%) were female, and 293 (95.8%) were foreign-born. Respiratory symptoms were present in 21.6%, and abnormal chest radiograph in 23.2%. Sputum culture positivity ranged from 12.9% in patients with no symptoms and normal lung parenchyma to 66.7% in patients with both. Respiratory symptoms, abnormal lung parenchyma, and HIV-coinfection (borderline) were independent predictors of sputum culture positivity (odds ratio [OR] 2.24 [95% confidence interval [CI] 1.15-4.39], P = 0.01, OR 4.78 [95% CI 2.41-9.48], P < 0.001, and OR 2.54 [95% CI 0.99-6.52], P = 0.05), respectively. Among contacts of sputum culture-positive PLNTB patients, one secondary case and 16 new infections were identified. Conclusion: Isochronous PTB is common in PLNTB patients. Routine screening of PLNTB patients for PTB is strongly recommended. |
| first_indexed | 2024-04-09T23:54:39Z |
| format | Article |
| id | doaj.art-69a0efefe6594fc482b822c314789a12 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-04-09T23:54:39Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-69a0efefe6594fc482b822c314789a122023-03-17T04:32:44ZengElsevierInternational Journal of Infectious Diseases1201-97122023-04-01129165174The prevalence, risk factors, and public health consequences of peripheral lymph node–associated clinical and subclinical pulmonary tuberculosisCourtney Heffernan0Mary Lou Egedahl1James Barrie2Christopher Winter3Gavin Armstrong4Alexander Doroshenko5Gregory Tyrrell6Catherine Paulsen7Angela Lau8Richard Long9Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaDepartment of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Corresponding author.Objectives: Relatively little is known about the prevalence, risk factors, and public health consequences of peripheral lymph node (PLN)–associated pulmonary tuberculosis (PTB). Methods: We developed a 10-year (2010-2019) population-based cohort of PLNTB patients in Canada. We used systematically collected primary source data and expert reader chest radiograph interpretations in a multivariable logistic regression to determine associations between sputum culture positivity and demographic, clinical, and radiographic features. Public health risks were estimated among contacts of PLNTB patients. Results: There were 306 patients with PLNTB, among whom 283 (92.5%) were 15-64 years of age, 159 (52.0%) were female, and 293 (95.8%) were foreign-born. Respiratory symptoms were present in 21.6%, and abnormal chest radiograph in 23.2%. Sputum culture positivity ranged from 12.9% in patients with no symptoms and normal lung parenchyma to 66.7% in patients with both. Respiratory symptoms, abnormal lung parenchyma, and HIV-coinfection (borderline) were independent predictors of sputum culture positivity (odds ratio [OR] 2.24 [95% confidence interval [CI] 1.15-4.39], P = 0.01, OR 4.78 [95% CI 2.41-9.48], P < 0.001, and OR 2.54 [95% CI 0.99-6.52], P = 0.05), respectively. Among contacts of sputum culture-positive PLNTB patients, one secondary case and 16 new infections were identified. Conclusion: Isochronous PTB is common in PLNTB patients. Routine screening of PLNTB patients for PTB is strongly recommended.http://www.sciencedirect.com/science/article/pii/S1201971223000267Peripheral lymph node tuberculosis |
| spellingShingle | Courtney Heffernan Mary Lou Egedahl James Barrie Christopher Winter Gavin Armstrong Alexander Doroshenko Gregory Tyrrell Catherine Paulsen Angela Lau Richard Long The prevalence, risk factors, and public health consequences of peripheral lymph node–associated clinical and subclinical pulmonary tuberculosis International Journal of Infectious Diseases Peripheral lymph node tuberculosis |
| title | The prevalence, risk factors, and public health consequences of peripheral lymph node–associated clinical and subclinical pulmonary tuberculosis |
| title_full | The prevalence, risk factors, and public health consequences of peripheral lymph node–associated clinical and subclinical pulmonary tuberculosis |
| title_fullStr | The prevalence, risk factors, and public health consequences of peripheral lymph node–associated clinical and subclinical pulmonary tuberculosis |
| title_full_unstemmed | The prevalence, risk factors, and public health consequences of peripheral lymph node–associated clinical and subclinical pulmonary tuberculosis |
| title_short | The prevalence, risk factors, and public health consequences of peripheral lymph node–associated clinical and subclinical pulmonary tuberculosis |
| title_sort | prevalence risk factors and public health consequences of peripheral lymph node associated clinical and subclinical pulmonary tuberculosis |
| topic | Peripheral lymph node tuberculosis |
| url | http://www.sciencedirect.com/science/article/pii/S1201971223000267 |
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