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Extrapulmonary tuberculosis in China: a national survey
Tao Li1, Xiangyu Yan2, Xin Du3
1Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health, Peking University, Beijing, China.
Summary
Extrapulmonary tuberculosis (EPTB) affects nearly a quarter of tuberculosis patients in China, with respiratory and musculoskeletal systems most commonly impacted. This study highlights the need to improve EPTB diagnosis and reporting nationwide.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Extrapulmonary tuberculosis (EPTB) represents a significant public health challenge in China, yet its national epidemic status remains largely uncharacterized.
- Despite not being a notifiable disease, EPTB contributes substantially to the overall tuberculosis burden.
Purpose of the Study:
- To determine the prevalence and primary subtypes of Extrapulmonary tuberculosis (EPTB) across China.
- To analyze the distribution of EPTB based on patient demographics and healthcare facility levels.
Main Methods:
- A national cross-sectional study was conducted from 2020 to 2021 using multistage, stratified cluster random sampling.
- Proportions of EPTB were calculated by organ system, and logistic regression models identified associated characteristics.
Main Results:
- Out of 6843 tuberculosis patients, 24.6% had EPTB, with 21.3% having EPTB exclusively.
- Higher EPTB prevalence was noted in children, females, clinically diagnosed cases, and in Central and West China.
- The most frequent EPTB sites were respiratory (35.5%), musculoskeletal (15.8%), and peripheral lymphatic (15.8%), with tuberculous pleurisy, spinal TB, and cervical tuberculous lymphadenopathy as leading subtypes.
Conclusions:
- Strengthening diagnostic and treatment capabilities for EPTB in primary healthcare settings is crucial.
- It is recommended that Extrapulmonary tuberculosis (EPTB) be designated as a notifiable disease within China's National Tuberculosis Program.
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