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Open Access Research article

Demographic and microbial characteristics of extrapulmonary tuberculosis cases diagnosed in Malatya, Turkey, 2001-2007

Selami Gunal1, Zhenhua Yang2, Mansi Agarwal2, Mehmet Koroglu3, Zeynep Kazgan Arıcı4 and Riza Durmaz1*

Author Affiliations

1 Department of Clinical Microbiology, Medical Faculty, Inonu University, Malatya, Turkey

2 Department of Epidemiology, University of Michigan, Ann Arbor, Michigan 48109, USA

3 Malatya Governor Research Hospital, Microbiology Laboratory, Malatya, Turkey

4 Tuberculosis Control Dispensary, Malatya, Turkey

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BMC Public Health 2011, 11:154  doi:10.1186/1471-2458-11-154

Published: 8 March 2011

Abstract

Background

Extrapulmonary tuberculosis (EPTB) has an increasing rate in Turkey. The reason remains largely unknown. A better understanding of the demographic and microbial characteristics of EPTB in the Turkish population would extend the knowledgebase of EPTB and allow us to develop better strategies to control tuberculosis (TB).

Methods

We retrospectively evaluated clinical and laboratory data of 397 bacteriologically-confirmed TB cases diagnosed during an eight year-period using by chi-square analysis and multivariate logistic regression model.

Results

Of the 397 study patients, 103 (25.9%) had EPTB and 294 (74.1%) had pulmonary tuberculosis (PTB). The most commonly seen two types of EPTB were genitourinary TB (27.2%) and meningeal TB (19.4%). TB in bone/joints, pleural cavity, lymph nodes, skin, and peritoneal cavity occurred at a frequency ranging from 9.7% to 10.7%. The age distribution was significantly different (P < 0.01) between PTB and EPTB, with patients older than 45 years tending to have an increased risk of EPTB. Furthermore, the distribution of different types of EPTB differed significantly among age groups (P = 0.03). Meningeal and bone and/or joint TB were more commonly observed among the male patients, while lymphatic, genitourinary, and peritoneal TB cases were more frequently seen among females. Unique strain infection was statistically significantly associated with EPTB (OR: 2.82, 95% CI [1.59, 5.00])

Conclusions

EPTB accounted for a significant proportion of TB cases in Malatya, Turkey between 2001 and 2007. The current study has provided an insight into the dynamics of EPTB in Malatya, Turkey. However, the risk factors for having EPTB in Malatya, Turkey remain to be assessed in future studies using population-based or randomly selected sample.