Epidemiology of peripheral lymph node tuberculosis and genotyping of M. tuberculosis strains: A case-control study

Chinmay Khandkar, Zinta Harrington, Peter J. Jelfs, Vitali Sintchenko, Claudia C. Dobler

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

Background: This study examined potential risk factors of lymph node tuberculosis (LNTB), including phylogenetic lineages of Mycobacterium tuberculosis (MTB), in comparison to pulmonary tuberculosis (PTB) in a setting with an ethnically diverse population. Methods: We conducted a case-control study at a major tuberculosis clinic in Sydney, Australia, which included all patients with peripheral LNTB seen at the clinic between 2000 and 2012. Controls were randomly selected patients with PTB seen at the same clinic during the study period. Epidemiological data were extracted from the hospital electronic database and medical records. Associations between LNTB and age, sex, ethnicity, comorbidities and phylogenetic lineages of MTB in comparison to PTB were examined using logistic regression in univariate and multivariate analyses. Results: There were 212 cases with LNTB and 424 randomly selected controls with PTB. Among patients with LNTB, 74% were female and the mean age (standard deviation, SD) was 42 (16) years. Among patients with PTB, 43% were female and the mean age was 44 (22) years. Females, 45 to 64-year-olds and Southern Asians had an increased risk for LNTB (OR 3.13, 95% CI 2.10-4.67; OR 2.50, 95% CI 1.29-4.84; OR 3.95, 95% CI 1.54-10.12 respectively). Patients with diabetes were at a higher risk of PTB (OR 0.40, 95% CI 0.19 - 0.83 for LNTB). A subset analysis showed that patients infected with the East African Indian strain of MTB were more likely to develop LNTB (OR 10.07, 95% CI 2.37-42.77). Conclusions: An increased risk for LNTB (but still lower rates than for PTB) was found among females, people aged 45 to 64 years and people born in Southern Asia. An increased risk for PTB was found among patients with diabetes. The East African Indian strain of MTB was significantly associated with a higher likelihood of LNTB compared to other MTB strains.

Original languageEnglish
Article numbere0132400
JournalPLoS One
Volume10
Issue number7
DOIs
Publication statusPublished - 15 Jul 2015
Externally publishedYes

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Lymph Node Tuberculosis
Epidemiology
case-control studies
tuberculosis
genotyping
lymph nodes
Case-Control Studies
epidemiology
Tuberculosis
Pulmonary Tuberculosis
Mycobacterium tuberculosis
Medical problems
lungs
Logistics
Electronic Health Records
diabetes
Comorbidity
Multivariate Analysis
Logistic Models
Databases

Cite this

Khandkar, Chinmay ; Harrington, Zinta ; Jelfs, Peter J. ; Sintchenko, Vitali ; Dobler, Claudia C. / Epidemiology of peripheral lymph node tuberculosis and genotyping of M. tuberculosis strains : A case-control study. In: PLoS One. 2015 ; Vol. 10, No. 7.
@article{3cc24ad344eb44f3b32efa1de74b6277,
title = "Epidemiology of peripheral lymph node tuberculosis and genotyping of M. tuberculosis strains: A case-control study",
abstract = "Background: This study examined potential risk factors of lymph node tuberculosis (LNTB), including phylogenetic lineages of Mycobacterium tuberculosis (MTB), in comparison to pulmonary tuberculosis (PTB) in a setting with an ethnically diverse population. Methods: We conducted a case-control study at a major tuberculosis clinic in Sydney, Australia, which included all patients with peripheral LNTB seen at the clinic between 2000 and 2012. Controls were randomly selected patients with PTB seen at the same clinic during the study period. Epidemiological data were extracted from the hospital electronic database and medical records. Associations between LNTB and age, sex, ethnicity, comorbidities and phylogenetic lineages of MTB in comparison to PTB were examined using logistic regression in univariate and multivariate analyses. Results: There were 212 cases with LNTB and 424 randomly selected controls with PTB. Among patients with LNTB, 74{\%} were female and the mean age (standard deviation, SD) was 42 (16) years. Among patients with PTB, 43{\%} were female and the mean age was 44 (22) years. Females, 45 to 64-year-olds and Southern Asians had an increased risk for LNTB (OR 3.13, 95{\%} CI 2.10-4.67; OR 2.50, 95{\%} CI 1.29-4.84; OR 3.95, 95{\%} CI 1.54-10.12 respectively). Patients with diabetes were at a higher risk of PTB (OR 0.40, 95{\%} CI 0.19 - 0.83 for LNTB). A subset analysis showed that patients infected with the East African Indian strain of MTB were more likely to develop LNTB (OR 10.07, 95{\%} CI 2.37-42.77). Conclusions: An increased risk for LNTB (but still lower rates than for PTB) was found among females, people aged 45 to 64 years and people born in Southern Asia. An increased risk for PTB was found among patients with diabetes. The East African Indian strain of MTB was significantly associated with a higher likelihood of LNTB compared to other MTB strains.",
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Epidemiology of peripheral lymph node tuberculosis and genotyping of M. tuberculosis strains : A case-control study. / Khandkar, Chinmay; Harrington, Zinta; Jelfs, Peter J.; Sintchenko, Vitali; Dobler, Claudia C.

In: PLoS One, Vol. 10, No. 7, e0132400, 15.07.2015.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Epidemiology of peripheral lymph node tuberculosis and genotyping of M. tuberculosis strains

T2 - A case-control study

AU - Khandkar, Chinmay

AU - Harrington, Zinta

AU - Jelfs, Peter J.

AU - Sintchenko, Vitali

AU - Dobler, Claudia C.

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N2 - Background: This study examined potential risk factors of lymph node tuberculosis (LNTB), including phylogenetic lineages of Mycobacterium tuberculosis (MTB), in comparison to pulmonary tuberculosis (PTB) in a setting with an ethnically diverse population. Methods: We conducted a case-control study at a major tuberculosis clinic in Sydney, Australia, which included all patients with peripheral LNTB seen at the clinic between 2000 and 2012. Controls were randomly selected patients with PTB seen at the same clinic during the study period. Epidemiological data were extracted from the hospital electronic database and medical records. Associations between LNTB and age, sex, ethnicity, comorbidities and phylogenetic lineages of MTB in comparison to PTB were examined using logistic regression in univariate and multivariate analyses. Results: There were 212 cases with LNTB and 424 randomly selected controls with PTB. Among patients with LNTB, 74% were female and the mean age (standard deviation, SD) was 42 (16) years. Among patients with PTB, 43% were female and the mean age was 44 (22) years. Females, 45 to 64-year-olds and Southern Asians had an increased risk for LNTB (OR 3.13, 95% CI 2.10-4.67; OR 2.50, 95% CI 1.29-4.84; OR 3.95, 95% CI 1.54-10.12 respectively). Patients with diabetes were at a higher risk of PTB (OR 0.40, 95% CI 0.19 - 0.83 for LNTB). A subset analysis showed that patients infected with the East African Indian strain of MTB were more likely to develop LNTB (OR 10.07, 95% CI 2.37-42.77). Conclusions: An increased risk for LNTB (but still lower rates than for PTB) was found among females, people aged 45 to 64 years and people born in Southern Asia. An increased risk for PTB was found among patients with diabetes. The East African Indian strain of MTB was significantly associated with a higher likelihood of LNTB compared to other MTB strains.

AB - Background: This study examined potential risk factors of lymph node tuberculosis (LNTB), including phylogenetic lineages of Mycobacterium tuberculosis (MTB), in comparison to pulmonary tuberculosis (PTB) in a setting with an ethnically diverse population. Methods: We conducted a case-control study at a major tuberculosis clinic in Sydney, Australia, which included all patients with peripheral LNTB seen at the clinic between 2000 and 2012. Controls were randomly selected patients with PTB seen at the same clinic during the study period. Epidemiological data were extracted from the hospital electronic database and medical records. Associations between LNTB and age, sex, ethnicity, comorbidities and phylogenetic lineages of MTB in comparison to PTB were examined using logistic regression in univariate and multivariate analyses. Results: There were 212 cases with LNTB and 424 randomly selected controls with PTB. Among patients with LNTB, 74% were female and the mean age (standard deviation, SD) was 42 (16) years. Among patients with PTB, 43% were female and the mean age was 44 (22) years. Females, 45 to 64-year-olds and Southern Asians had an increased risk for LNTB (OR 3.13, 95% CI 2.10-4.67; OR 2.50, 95% CI 1.29-4.84; OR 3.95, 95% CI 1.54-10.12 respectively). Patients with diabetes were at a higher risk of PTB (OR 0.40, 95% CI 0.19 - 0.83 for LNTB). A subset analysis showed that patients infected with the East African Indian strain of MTB were more likely to develop LNTB (OR 10.07, 95% CI 2.37-42.77). Conclusions: An increased risk for LNTB (but still lower rates than for PTB) was found among females, people aged 45 to 64 years and people born in Southern Asia. An increased risk for PTB was found among patients with diabetes. The East African Indian strain of MTB was significantly associated with a higher likelihood of LNTB compared to other MTB strains.

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DO - 10.1371/journal.pone.0132400

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