Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jul 15;10(7):e0132400.
doi: 10.1371/journal.pone.0132400. eCollection 2015.

Epidemiology of Peripheral Lymph Node Tuberculosis and Genotyping of M. tuberculosis Strains: A Case-Control Study

Chinmay Khandkar  1 , Zinta Harrington  1 , Peter J Jelfs  2 , Vitali Sintchenko  3 , Claudia C Dobler  1
Affiliations

Epidemiology of Peripheral Lymph Node Tuberculosis and Genotyping of M. tuberculosis Strains: A Case-Control Study

Chinmay Khandkar et al. PLoS One. .

Abstract

Background: This study examined potential risk factors of lymph node tuberculosis (LNTB), including phylogenetic lineages of Mycobacterium tuberculosis (MTB), in comparison to pulmonary tuberculosis (PTB) in a setting with an ethnically diverse population.

Methods: We conducted a case-control study at a major tuberculosis clinic in Sydney, Australia, which included all patients with peripheral LNTB seen at the clinic between 2000 and 2012. Controls were randomly selected patients with PTB seen at the same clinic during the study period. Epidemiological data were extracted from the hospital electronic database and medical records. Associations between LNTB and age, sex, ethnicity, comorbidities and phylogenetic lineages of MTB in comparison to PTB were examined using logistic regression in univariate and multivariate analyses.

Results: There were 212 cases with LNTB and 424 randomly selected controls with PTB. Among patients with LNTB, 74% were female and the mean age (standard deviation, SD) was 42 (16) years. Among patients with PTB, 43% were female and the mean age was 44 (22) years. Females, 45 to 64-year-olds and Southern Asians had an increased risk for LNTB (OR 3.13, 95% CI 2.10-4.67; OR 2.50, 95% CI 1.29-4.84; OR 3.95, 95% CI 1.54-10.12 respectively). Patients with diabetes were at a higher risk of PTB (OR 0.40, 95% CI 0.19 - 0.83 for LNTB). A subset analysis showed that patients infected with the East African Indian strain of MTB were more likely to develop LNTB (OR 10.07, 95% CI 2.37-42.77).

Conclusions: An increased risk for LNTB (but still lower rates than for PTB) was found among females, people aged 45 to 64 years and people born in Southern Asia. An increased risk for PTB was found among patients with diabetes. The East African Indian strain of MTB was significantly associated with a higher likelihood of LNTB compared to other MTB strains.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Ratio of females to males in LNTB cohorts of published studies.
See this image and copyright information in PMC

References

    1. World Health Organisation. Global Tuberculosis Report 2012. Geneva, Switzerland: 2012.
    1. Zumla A, Raviglione M, Hafner R, von Reyn CF. Tuberculosis. The New England journal of medicine. 2013. February 21;368(8):745–55. 10.1056/NEJMra1200894 - DOI - PubMed
    1. Bareja C, Waring J, Stapledon R, Toms C, Douglas P. Tuberculosis Notifications in Australia, 2011. Communicable Diseases Intelligence. 2014;38(4):356–68. - PubMed
    1. Lowbridge C, Christensen A, McAnulty JM. EpiReview: tuberculosis in NSW, 2009–2011. New South Wales public health bulletin. 2013;24(1):3–9. 10.1071/NB12115 - DOI - PubMed
    1. Farer LS, Lowell AM, Meador MP. Extrapulmonary tuberculosis in the United States. American Journal of Epidemiology. 1979;109(2):205–17. - PubMed

LinkOut - more resources