Search

In order to assess the confusion attendant with current definitions of extrapulmonary tuberculosis, pleural and miliary disease, a set of 37 papers published which analyzed disease states were assessed for how the terms adhered to official definitions of the American Thoracic Society, the World Health Organization, and the Centers for Disease Control. The findings showed uncertainties in the classification of extrapulmonary disease, a frequent inconsistency in the inclusion of pleural disease within pulmonary rather than extrapulmonary disease, and the ambivalent use of the terms pleural and disseminated tuberculosis. Further attention by editors and authors is needed in the use of tuberculosis definitions.

Aims: To assess the definitions used by authors for pulmonary and extrapulmonary tuberculosis, definitions which are ostensibly standardized in the literature by the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and American Thoracic Society (ATS) definitions. Methodology: Thirty-seven papers used for the study of extrapulmonary tuberculosis, identified by PubMed and Google Scholar searches identified through an earlier study on extrapulmonary tuberculosis and updated, were analyzed for specifics regarding how extrapulmonary, pulmonary, pleural and disseminated tuberculosis were defined. Data were tabulated and analyzed using STATA 11. Results: Thirty-one (84%) of the papers provided data on the numbers of pulmonary and extra-pulmonary cases. The papers were from 34 institutions in 20 nations. Only 14 (38%) of the series reported the number of patients with combined pulmonary and extrapulmonary disease. Among all patients, in only four were the combined patients analyzed as a completely separate category with combined cases otherwise excluded (11), counted as extrapulmonary (7), as pulmonary (3) or both extrapulmonary and pulmonary (1) tuberculosis or unclearly documented (11). Pleural disease was included as extrapulmonary in 25 patients (68%), but as pulmonary in 4 (11%), and there was no criterion in the remaining 8 (22%). In 18 of the studies where disseminated or miliary disease were defined, 5 of the disseminated were categorized otherwise (e.g., along with combined pulmonary and extrapulmonary cases). Conclusion: There is much confusion in the categorization of clinical tuberculosis. The standardized WHO, CDC, and ATS definitions are not always adhered to in collating and analyzing tuberculosis data by authors studying extrapulmonary tuberculosis. The recommendation that pleural disease be considered extrapulmonary is not adhered to in a sizable percentage (32%) of studies and the exclusion of disseminated or miliary disease in a subset of patients is also inconsistent. More restrictive guidelines are needed in the definitions used for tuberculosis so that studies and meta-analyses can be performed with greater validity.

In order to assess the confusion attendant with current definitions of extrapulmonary tuberculosis, pleural and miliary disease, a set of 37 papers published which analyzed disease states were assessed for how the terms adhered to official definitions of the American Thoracic Society, the World Health Organization, and the Centers for Disease Control. The findings showed uncertainties in the classification of extrapulmonary disease, a frequent inconsistency in the inclusion of pleural disease within pulmonary rather than extrapulmonary disease, and the ambivalent use of the terms pleural and disseminated tuberculosis. Further attention by editors and authors is needed in the use of tuberculosis definitions. [ABSTRACT FROM AUTHOR]

Aims and objectives: Extra-pulmonary tuberculosis (EPT) previously considered as rare would seems to be progressing thus constituting, at present, a real public health problem. Methods: Our study aims to determine frequency and characteristics of PET diagnosed in the medical microbiology department of CHU Mustapha (MMDCM), Algiers. A retrospective descriptive study was conducted over 3 years (2012, 2013 and 2014) identifying cases of PET diagnosed in the MMDCM. Results: From January 2012 to December 2014, 3529 samples were received at MMDCM and seeded in culture on Löwenstein -Jensen: 1814 from pulmonary origin and 1715 from extra-pulmonary sites. Of the 153 positive cultures, 74 were extra-pulmonary, ie 48.4%. Pleural tuberculosis was the most reported form (39%). Peritoneal and pericardial tuberculosis were also reported at 6.75% and 2.70% respectively. The neuro-meningeal, osteoarticular and lymph node forms accounted for 5.4%, 10.8% and 9.45%, respectively. We noted a slight predominance of women. Conclusions: The EPT rate determined during our study reflects the progress of this infection. There is also a diversity of clinical forms, which should encourage systematic bacteriological confirmation of suspected cases, to ensure regular and continuous monitoring. [ABSTRACT FROM AUTHOR]

Aims To assess the definitions used by authors for pulmonary and extrapulmonary tuberculosis, definitions which are ostensibly standardized in the literature by the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and American Thoracic Society (ATS) definitions. Methodology Thirty-seven papers used for the study of extrapulmonary tuberculosis, identified by PubMed and Google Scholar searches identified through an earlier study on extrapulmonary tuberculosis and updated, were analyzed for specifics regarding how extrapulmonary, pulmonary, pleural and disseminated tuberculosis were defined. Data were tabulated and analyzed using STATA 11. Results Thirty-one (84%) of the papers provided data on the numbers of pulmonary and extra-pulmonary cases. The papers were from 34 institutions in 20 nations. Only 14 (38%) of the series reported the number of patients with combined pulmonary and extrapulmonary disease. Among all patients, in only four were the combined patients analyzed as a completely separate category with combined cases otherwise excluded (11), counted as extrapulmonary (7), as pulmonary (3) or both extrapulmonary and pulmonary (1) tuberculosis or unclearly documented (11). Pleural disease was included as extrapulmonary in 25 patients (68%), but as pulmonary in 4 (11%), and there was no criterion in the remaining 8 (22%). In 18 of the studies where disseminated or miliary disease were defined, 5 of the disseminated were categorized otherwise (e.g., along with combined pulmonary and extrapulmonary cases). Conclusion There is much confusion in the categorization of clinical tuberculosis. The standardized WHO, CDC, and ATS definitions are not always adhered to in collating and analyzing tuberculosis data by authors studying extrapulmonary tuberculosis. The recommendation that pleural disease be considered extrapulmonary is not adhered to in a sizable percentage (32%) of studies and the exclusion of disseminated or miliary disease in a subset of patients is also inconsistent. More restrictive guidelines are needed in the definitions used for tuberculosis so that studies and meta-analyses can be performed with greater validity. [ABSTRACT FROM AUTHOR]