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Clinical differences between pulmonary and extrapulmonary tuberculosis: a 5-year retrospective study

S J Antony1, V Harrell, J D Christie

  • 1Department of Medicine, East Carolina University School of Medicine, Greenville, North Carolina, USA.

Journal of the National Medical Association
|March 1, 1995
PubMed
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This study highlights that impoverished rural areas are significant reservoirs for tuberculosis (TB) resurgence. Tuberculosis characteristics and risk factors were analyzed in Eastern North Carolina from 1988-1992.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Tuberculosis (TB) remains a significant public health concern, particularly in rural areas.
  • Understanding the specific characteristics of TB in diverse populations is crucial for effective control strategies.
  • Eastern North Carolina, a predominantly rural region, presented a unique demographic for TB analysis.

Purpose of the Study:

  • To describe the clinical, epidemiologic, laboratory, and treatment features of pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB).
  • To identify factors associated with PTB and EPTB in a rural North Carolina population.
  • To emphasize the role of impoverished rural areas as reservoirs for TB resurgence.

Main Methods:

  • Retrospective analysis of culture-positive TB cases from 1988-1992.

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  • Data collected from the University Medical Center of Eastern North Carolina-Pitt County and East Carolina University School of Medicine.
  • Analysis included demographic, clinical, and laboratory data for 138 patients.

    • Main Results:

    • Pulmonary tuberculosis (PTB) affected 56% and extrapulmonary tuberculosis (EPTB) 44% of patients.
    • African-American males comprised 59% of the study population, with 69% uninsured.
    • Factors associated with PTB included white males, diabetes, and cancer; EPTB was linked to HIV serology, low hematocrit, and elevated alkaline phosphatase.

    Conclusions:

    • Impoverished rural areas are critical reservoirs for ongoing tuberculosis resurgence.
    • Specific risk factors identified for PTB and EPTB require targeted public health interventions.
    • Control efforts must address the unique challenges and reservoirs in underserved rural communities.