Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study

Detalhes bibliográficos
Autor(a) principal: Zürcher, Kathrin
Data de Publicação: 2019
Outros Autores: Ballif, Marie, Kiertiburanakul, Sasisopin, Chenal, Henri, Yotebieng, Marcel, Grinsztejn, Beatriz, Michael, Denna, Sterling, Timothy R., Ngonyani, Kapella M., Mandalakas, Anna M., Egger, Matthias, Pettit, April C., Fenner, Lukas
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/36060
Resumo: University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.
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spelling Zürcher, KathrinBallif, MarieKiertiburanakul, SasisopinChenal, HenriYotebieng, MarcelGrinsztejn, BeatrizMichael, DennaSterling, Timothy R.Ngonyani, Kapella M.Mandalakas, Anna M.Egger, MatthiasPettit, April C.Fenner, Lukas2019-10-02T13:16:56Z2019-10-02T13:16:56Z2019ZÜRCHER, Kathrin et al. Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study. Journal of the International AIDS Society, v. 22, p. 1-10, 2019.1758-2652https://www.arca.fiocruz.br/handle/icict/3606010.1002/jia2.253921758-2652engWiley Open AccessDiagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleUniversity of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.Mahidol University. Faculty of Medicine. Ramathibodi Hospital. Bangkok, Thailand.Centre Intégré de Recherches Biocliniques d’Abidjan. Abidjan, Cotê d’Ivoire.Ohio State University. College of Public Health. Columbus, OH, USAFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.National Institute for Medical Research, Kisesa HDSS. Mwanza, Tanzania.Vanderbilt Tuberculosis Center. Nashville, TN, USA / Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.Tumbi Special Hospital, CTC, Kibaha Town, TanzaniaBaylor College of Medicine. Global Tuberculosis Program. Houston, TX, USA / Texas Children’s Hospital. Houston, TX, USA.University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland / University of Cape Town. School of Public Health & Family Medicine. Centre for Infectious Disease Epidemiology & Research. Cape Town, South Africa.Vanderbilt Tuberculosis Center. Nashville, TN, USA / Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.Introduction: Extrapulmonary tuberculosis (EPTB) is difficult to confirm bacteriologically and requires specific diagnostic capacities. Diagnosis can be especially challenging in under-resourced settings. We studied diagnostic modalities and clinical outcomes of EPTB compared to pulmonary tuberculosis (PTB) among HIV-positive adults in antiretroviral therapy (ART) programmes in low- and middle-income countries (LMIC). Methods: We collected data from HIV-positive TB patients (≥16 years) in 22 ART programmes participating in the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium in sub-Saharan Africa, Asia-Pacific, and Caribbean, Central and South America regions between 2012 and 2014. We categorized TB as PTB or EPTB (EPTB included mixed PTB/EPTB). We used multivariable logistic regression to assess associations with clinical outcomes. Results and Discussion: We analysed 2695 HIV-positive TB patients. Median age was 36 years (interquartile range (IQR) 30 to 43), 1102 were female (41%), and the median CD4 count at TB treatment start was 114 cells/lL (IQR 40 to 248). Overall, 1930 had PTB (72%), and 765 EPTB (28%). Among EPTB patients, the most frequently involved sites were the lymph nodes (24%), pleura (15%), abdomen (11%) and meninges (6%). The majority of PTB (1123 of 1930, 58%) and EPTB (582 of 765, 76%) patients were diagnosed based on clinical criteria. Bacteriological confirmation (using positive smear microscopy, culture, Xpert MTB/RIF, or other nucleic acid amplification tests result) was obtained in 897 of 1557 PTB (52%) and 183 of 438 EPTB (42%) patients. EPTB was not associated with higher mortality compared to PTB (adjusted odd ratio (aOR) 1.0, 95% CI 0.8 to 1.3), but TB meningitis was (aOR 1.9, 95% CI 1.0 to 3.1). Bacteriological confirmation was associated with reduced mortality among PTB patients (aOR 0.7, 95% CI 0.6 to 0.8) and EPTB patients (aOR 0.3 95% CI 0.1 to 0.8) compared to TB patients with a negative test result. Conclusions: Diagnosis of EPTB and PTB at ART programmes in LMIC was mainly based on clinical criteria. Greater availability and usage of TB diagnostic tests would improve the diagnosis and clinical outcomes of both EPTB and PTB.Extrapulmonary tuberculosisPulmonary tuberculosisTuberculosisHIV-positive patientsLow- and middle-income countriesDiagnosticsMortalityLost to follow-upinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83104https://www.arca.fiocruz.br/bitstream/icict/36060/1/license.txt79178e5f2a0eb066867a274556814938MD51ORIGINALve_Zürcher_Kathrin_etal_INI_2109.pdfve_Zürcher_Kathrin_etal_INI_2109.pdfapplication/pdf631628https://www.arca.fiocruz.br/bitstream/icict/36060/2/ve_Z%c3%bcrcher_Kathrin_etal_INI_2109.pdffc8c1d9a582191abdd8385c783e740bfMD52TEXTve_Zürcher_Kathrin_etal_INI_2109.pdf.txtve_Zürcher_Kathrin_etal_INI_2109.pdf.txtExtracted 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dc.title.pt_BR.fl_str_mv Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study
title Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study
spellingShingle Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study
Zürcher, Kathrin
Extrapulmonary tuberculosis
Pulmonary tuberculosis
Tuberculosis
HIV-positive patients
Low- and middle-income countries
Diagnostics
Mortality
Lost to follow-up
title_short Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study
title_full Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study
title_fullStr Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study
title_full_unstemmed Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study
title_sort Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study
author Zürcher, Kathrin
author_facet Zürcher, Kathrin
Ballif, Marie
Kiertiburanakul, Sasisopin
Chenal, Henri
Yotebieng, Marcel
Grinsztejn, Beatriz
Michael, Denna
Sterling, Timothy R.
Ngonyani, Kapella M.
Mandalakas, Anna M.
Egger, Matthias
Pettit, April C.
Fenner, Lukas
author_role author
author2 Ballif, Marie
Kiertiburanakul, Sasisopin
Chenal, Henri
Yotebieng, Marcel
Grinsztejn, Beatriz
Michael, Denna
Sterling, Timothy R.
Ngonyani, Kapella M.
Mandalakas, Anna M.
Egger, Matthias
Pettit, April C.
Fenner, Lukas
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Zürcher, Kathrin
Ballif, Marie
Kiertiburanakul, Sasisopin
Chenal, Henri
Yotebieng, Marcel
Grinsztejn, Beatriz
Michael, Denna
Sterling, Timothy R.
Ngonyani, Kapella M.
Mandalakas, Anna M.
Egger, Matthias
Pettit, April C.
Fenner, Lukas
dc.subject.en.pt_BR.fl_str_mv Extrapulmonary tuberculosis
Pulmonary tuberculosis
Tuberculosis
HIV-positive patients
Low- and middle-income countries
Diagnostics
Mortality
Lost to follow-up
topic Extrapulmonary tuberculosis
Pulmonary tuberculosis
Tuberculosis
HIV-positive patients
Low- and middle-income countries
Diagnostics
Mortality
Lost to follow-up
description University of Bern. Institute of Social and Preventive Medicine. Bern, Switzerland.
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-10-02T13:16:56Z
dc.date.available.fl_str_mv 2019-10-02T13:16:56Z
dc.date.issued.fl_str_mv 2019
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv ZÜRCHER, Kathrin et al. Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study. Journal of the International AIDS Society, v. 22, p. 1-10, 2019.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/36060
dc.identifier.issn.pt_BR.fl_str_mv 1758-2652
dc.identifier.doi.none.fl_str_mv 10.1002/jia2.25392
dc.identifier.eissn.none.fl_str_mv 1758-2652
identifier_str_mv ZÜRCHER, Kathrin et al. Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study. Journal of the International AIDS Society, v. 22, p. 1-10, 2019.
1758-2652
10.1002/jia2.25392
url https://www.arca.fiocruz.br/handle/icict/36060
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Wiley Open Access
publisher.none.fl_str_mv Wiley Open Access
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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