Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend
The aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical...
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| Veröffentlicht in: | Epidemiology and infection 2018-12, Vol.146 (16), p.2107-2115 |
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| creator | Mann, T N Schaaf, H S Dunn, R N Dix-Peek, S du Preez, K Lamberts, R P du Toit, J Davis, J H |
| description | The aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6-4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases. |
| doi_str_mv | 10.1017/S0950268818002649 |
| format | Article |
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All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6-4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases.</description><identifier>ISSN: 0950-2688</identifier><identifier>EISSN: 1469-4409</identifier><identifier>DOI: 10.1017/S0950268818002649</identifier><identifier>PMID: 30264687</identifier><language>eng</language><publisher>England: Cambridge University Press</publisher><subject>Adolescent ; Adult ; Adults ; Child ; Child, Preschool ; Children ; Confidence intervals ; Cost of Illness ; Demographics ; Drug therapy ; Epidemiology ; Female ; Hospitals ; Humans ; Infant ; Infections ; Kyphosis ; Kyphosis - epidemiology ; Kyphosis - pathology ; Lung diseases ; Male ; Medical records ; Middle Aged ; NMR ; Nuclear magnetic resonance ; Original Paper ; Population ; Prevalence ; Public health ; Retrospective Studies ; South Africa - epidemiology ; Surgery ; Systematic review ; Tertiary Care Centers ; Tuberculosis ; Tuberculosis, Spinal - complications ; Tuberculosis, Spinal - epidemiology ; Tuberculosis, Spinal - pathology ; Vertebrae ; Vigilance ; Young Adult</subject><ispartof>Epidemiology and infection, 2018-12, Vol.146 (16), p.2107-2115</ispartof><rights>Copyright © Cambridge University Press 2018</rights><rights>Cambridge University Press 2018 2018 Cambridge University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-240ca3623486d95cf87657e653fe088abe5fc9acf0db2b2c210398643efdc1423</citedby><cites>FETCH-LOGICAL-c427t-240ca3623486d95cf87657e653fe088abe5fc9acf0db2b2c210398643efdc1423</cites><orcidid>0000-0002-9750-5106</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453008/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6453008/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,27926,27927,53793,53795</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30264687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mann, T N</creatorcontrib><creatorcontrib>Schaaf, H S</creatorcontrib><creatorcontrib>Dunn, R N</creatorcontrib><creatorcontrib>Dix-Peek, S</creatorcontrib><creatorcontrib>du Preez, K</creatorcontrib><creatorcontrib>Lamberts, R P</creatorcontrib><creatorcontrib>du Toit, J</creatorcontrib><creatorcontrib>Davis, J H</creatorcontrib><title>Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend</title><title>Epidemiology and infection</title><addtitle>Epidemiol Infect</addtitle><description>The aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6-4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Confidence intervals</subject><subject>Cost of Illness</subject><subject>Demographics</subject><subject>Drug therapy</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infections</subject><subject>Kyphosis</subject><subject>Kyphosis - epidemiology</subject><subject>Kyphosis - pathology</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Original Paper</subject><subject>Population</subject><subject>Prevalence</subject><subject>Public health</subject><subject>Retrospective Studies</subject><subject>South Africa - epidemiology</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Tertiary Care Centers</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Spinal - complications</subject><subject>Tuberculosis, Spinal - epidemiology</subject><subject>Tuberculosis, Spinal - pathology</subject><subject>Vertebrae</subject><subject>Vigilance</subject><subject>Young Adult</subject><issn>0950-2688</issn><issn>1469-4409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNplkctrFTEYxYMo9lr9A9xIwI0LR_OaTOKiUC6-oOCiisuQyXzjpMxNrnkI_e_N2Fp8LMK3OL_vJCcHoaeUvKKEDq8vie4Jk0pRRdoU-h7aUSF1JwTR99Fuk7tNP0GPcr4ihGimhofohG-0VMMOlf3i1wnb0M5U14Lz0Qe74lJHSK6uMfuMbcEFUvE2XeMlNqLYNWMfcFkAf4XcxID39ggv8WWsZcHnc_LOvsGiuwab8FjTBOHXJSVBmB6jB3NzgCe38xR9eff28_5Dd_Hp_cf9-UXnBBtKxwRxlkvGhZKT7t2sBtkPIHs-A1HKjtDPTls3k2lkI3OMEq6VFBzmyVHB-Ck6u_E91vEAk4NQkl3NMflDi2Ki9eZvJfjFfIs_jBQ9J0Q1gxe3Bil-ry2oOfjsYF1tgFizYZSKgRDBN_T5P-hVrKl95UZx2lOmpWwUvaFcijknmO8eQ4nZOjX_ddp2nv2Z4m7jd4n8JxiMnQY</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Mann, T N</creator><creator>Schaaf, H S</creator><creator>Dunn, R N</creator><creator>Dix-Peek, S</creator><creator>du Preez, K</creator><creator>Lamberts, R P</creator><creator>du Toit, J</creator><creator>Davis, J H</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T2</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9750-5106</orcidid></search><sort><creationdate>20181201</creationdate><title>Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend</title><author>Mann, T N ; Schaaf, H S ; Dunn, R N ; Dix-Peek, S ; du Preez, K ; Lamberts, R P ; du Toit, J ; Davis, J H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c427t-240ca3623486d95cf87657e653fe088abe5fc9acf0db2b2c210398643efdc1423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Confidence intervals</topic><topic>Cost of Illness</topic><topic>Demographics</topic><topic>Drug therapy</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infections</topic><topic>Kyphosis</topic><topic>Kyphosis - epidemiology</topic><topic>Kyphosis - pathology</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Original Paper</topic><topic>Population</topic><topic>Prevalence</topic><topic>Public health</topic><topic>Retrospective Studies</topic><topic>South Africa - epidemiology</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Tertiary Care Centers</topic><topic>Tuberculosis</topic><topic>Tuberculosis, Spinal - complications</topic><topic>Tuberculosis, Spinal - epidemiology</topic><topic>Tuberculosis, Spinal - pathology</topic><topic>Vertebrae</topic><topic>Vigilance</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mann, T N</creatorcontrib><creatorcontrib>Schaaf, H S</creatorcontrib><creatorcontrib>Dunn, R N</creatorcontrib><creatorcontrib>Dix-Peek, S</creatorcontrib><creatorcontrib>du Preez, K</creatorcontrib><creatorcontrib>Lamberts, R P</creatorcontrib><creatorcontrib>du Toit, J</creatorcontrib><creatorcontrib>Davis, J H</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Epidemiology and infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mann, T N</au><au>Schaaf, H S</au><au>Dunn, R N</au><au>Dix-Peek, S</au><au>du Preez, K</au><au>Lamberts, R P</au><au>du Toit, J</au><au>Davis, J H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend</atitle><jtitle>Epidemiology and infection</jtitle><addtitle>Epidemiol Infect</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>146</volume><issue>16</issue><spage>2107</spage><epage>2115</epage><pages>2107-2115</pages><issn>0950-2688</issn><eissn>1469-4409</eissn><abstract>The aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6-4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases.</abstract><cop>England</cop><pub>Cambridge University Press</pub><pmid>30264687</pmid><doi>10.1017/S0950268818002649</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-9750-5106</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; JSTOR Archive Collection A-Z Listing; PubMed Central |
| subjects | Adolescent Adult Adults Child Child, Preschool Children Confidence intervals Cost of Illness Demographics Drug therapy Epidemiology Female Hospitals Humans Infant Infections Kyphosis Kyphosis - epidemiology Kyphosis - pathology Lung diseases Male Medical records Middle Aged NMR Nuclear magnetic resonance Original Paper Population Prevalence Public health Retrospective Studies South Africa - epidemiology Surgery Systematic review Tertiary Care Centers Tuberculosis Tuberculosis, Spinal - complications Tuberculosis, Spinal - epidemiology Tuberculosis, Spinal - pathology Vertebrae Vigilance Young Adult |
| title | Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend |
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