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Non-respiratory tuberculosis in Canada. Epidemiologic and bacteriologic features
American Journal of Epidemiology
|September 1, 1980
Summary
Non-respiratory tuberculosis cases, common in genitourinary and lymphadenitis sites, declined overall but lymphadenitis persisted, especially in Asian-born females. Increased clinical awareness is needed due to diagnostic delays.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) primarily affects the respiratory system, but non-respiratory forms are significant.
- Understanding the epidemiology of non-respiratory TB is crucial for targeted public health interventions.
- Trends in non-respiratory TB manifestations require ongoing surveillance.
Purpose of the Study:
- To analyze the incidence and trends of non-respiratory tuberculosis in Canada from 1970-1977.
- To identify demographic patterns (age, sex, birthplace, ethnicity) associated with specific non-respiratory TB sites.
- To assess diagnostic challenges and drug resistance in non-respiratory TB cases.
Main Methods:
- Retrospective analysis of Canadian tuberculosis case data from 1970-1977.
- Categorization of TB cases by organ system involvement (non-respiratory sites).
- Examination of demographic factors, microbiological data, and diagnostic outcomes.
Main Results:
- Non-respiratory TB constituted approximately one-sixth of total cases (3671/21891), with genitourinary TB and lymphadenitis being most common.
- Morbidity rates for most non-respiratory TB sites declined between 1967-1977, except for lymphadenitis, which showed less decline.
- Lymphadenitis disproportionately affected females and individuals born in Asia, while meningitis decline was marked.
- Mycobacterium bovis isolation and drug resistance were infrequent.
- Concurrent or prior active TB was common, yet diagnosis was often delayed or missed.
Conclusions:
- Non-respiratory tuberculosis presents diverse epidemiological patterns, with lymphadenitis showing unique trends linked to immigration.
- Demographic variations highlight specific populations at higher risk for certain non-respiratory TB forms.
- Despite declining overall rates, diagnostic delays and challenges persist, necessitating heightened clinical vigilance for non-respiratory TB presentations.