Tuberculosis-Related Hospitalizations in a Low-Incidence Country: A Retrospective Analysis in Two Italian Infectious Diseases Wards
Abstract
1. Introduction
2. Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
CI | confidence interval |
DST | drug susceptibility test |
ECDC | European Center for Disease Prevention and Control |
EPTB | extrapulmonary tuberculosis |
ERS | European Respiratory Society |
HIV | human immunodeficiency virus |
IGRA | interferon-gamma release assay |
IQR | interquartile range |
MDR | multi-drug-resistant |
MTB | Mycobacterium tuberculosis |
NTM | nontuberculous mycobacteria |
PTB | pulmonary tuberculosis |
SD | standard deviation |
TB | tuberculosis |
USA | United States of America |
XDR | extensively drug-resistant |
WHO | World Health Organization |
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Variables | Overall n = 166 | Italian (n = 52) | Foreign-Born (n = 114) | p-Value & | |
---|---|---|---|---|---|
Year of diagnosis, n (%) | 2013 | 17 (10.2) | 3 (5.8) | 14 (12.3) | 0.29 |
2014 | 20 (12.1) | 6 (11.5) | 14 (12.3) | ||
2015 | 34 (20.5) | 13 (25.0) | 21 (18.4) | ||
2016 | 58 (34.9) | 22 (42.3) | 36 (31.6) | ||
2017 | 37 (22.3) | 8 (15.4) | 29 (25.4) | ||
Median (IQR) age, years | 37 (26–55) | 71.5 (44.5–80.0) | 30 (24–40) | <0.0001 | |
Age >65 years | 31 (18.7) | 31 (59.62) | 0 (0.0) | <0.0001 | |
Age group, n (%) | 0–24 | 31 (18.7) | 2 (3.9) | 29 (25.4) | 0.001 |
25–44 | 74 (44.6) | 11 (21.2) | 63 (55.3) | <0.0001 | |
45–64 | 30 (18.1) | 8 (15.4) | 22 (19.3) | 0.55 | |
65–79 | 17 (10.2) | 17 (32.7) | 0 (0.0) | <0.0001 | |
≥80 | 14 (8.4) | 14 (26.9) | 0 (0.0) | <0.0001 | |
Males, n (%) | 118 (71.1) | 32 (61.5) | 86 (75.4) | 0.07 | |
Immunodepression, n (%) | 45 (27.1) | 25 (48.1) | 20 (17.5) | <0.0001 | |
Causes of immunodepression, n (%) | HIV positivity | 14 (31.1) | 4 (16.0) | 10 (50.0) | 0.01 |
Hematological diseases | 6 (13.3) | 6 (24.0) | 0 (0.0) | 0.02 | |
Alcohol | 4 (8.9) | 1 (4.0) | 3 (15.0) | 0.20 | |
Diabetes mellitus | 4 (8.9) | 2 (8.0) | 2 (10.0) | 0.82 | |
Solid tumor | 4 (8.9) | 4 (16.0) | 0 (0.0) | 0.06 | |
Malnutrition | 4 (8.9) | 1 (4.0) | 3 (15.0) | 0.20 | |
Autoimmune disease | 3 (6.7) | 3 (12.0) | 0 (0.0) | 0.11 | |
Chronic renal failure | 2 (4.4) | 1 (4.0) | 1 (5.0) | 0.87 | |
Other diseases | 4 (8.9) | 3 (12.0) | 1 (5.0) | 0.41 | |
Comorbidity *, n (%) | 39 (23.5) | 23 (44.2) | 16 (14.0) | <0.0001 | |
TB form, n (%) | PTB ** | 95 (57.2) | 32 (61.5) | 63 (55.3) | 0.66 |
EPTB *** | 61 (36.8) | 18 (34.6) | 43 (37.7) | ||
PTB and EPTB | 10 (6.0) | 2 (3.9) | 8 (7.0) | ||
TB drug resistance, n (%) | 16 (13.0) | 1 (2.9) | 15 (17.1) | 0.04 |
Variables | Pulmonary (n = 95) | Extrapulmonary (n = 61) | p-Value | |
---|---|---|---|---|
Year of diagnosis, n (%) | 2013 | 11 (11.6) | 5 (8.2) | 0.74 |
2014 | 12 (12.6) | 7 (11.5) | ||
2015 | 18 (19.0) | 13 (21.3) | ||
2016 | 31 (32.6) | 25 (41.0) | ||
2017 | 23 (24.2) | 11 (18.0) | ||
Median (IQR) age, years | 39 (29–58) | 32 (24–55) | 0.07 | |
Age >65 years | 19 (20.0) | 12 (19.7) | 0.96 | |
Age group, n (%) | 0–24 | 10 (10.5) | 16 (26.2) | 0.13 |
25–44 | 48 (50.5) | 23 (37.7) | ||
45–64 | 18 (19.0) | 10 (16.4) | ||
65–79 | 10 (10.5) | 7 (11.5) | ||
≥80 | 9 (9.5) | 5 (8.2) | ||
Males, n (%) | 65 (68.4) | 45 (73.8) | 0.48 | |
Geographical area of origin, n (%) | Italy | 32 (33.7) | 18 (29.5) | 0.59 |
Africa | 19 (20.0) | 24 (39.3) | 0.01 | |
Europe | 35 (36.8) | 7 (11.5) | 0.001 | |
Other countries * | 9 (9.5) | 12 (19.7) | 0.07 | |
Immunodepression, n (%) | 17 (17.9) | 23 (37.7) | 0.006 | |
Causes of immunodepression, n (%) | HIV positivity | 3 (17.7) | 10 (43.5) | 0.18 |
Hematological diseases | 1 (5.9) | 5 (21.7) | ||
Alcohol | 4 (23.5) | 0 (0.0) | ||
Diabetes mellitus | 2 (11.8) | 2 (8.7) | ||
Solid tumor | 2 (11.8) | 2 (8.7) | ||
Malnutrition | 0 (0.0) | 1 (4.4) | ||
Autoimmune disease | 2 (11.8) | 1 (4.4) | ||
Chronic renal failure | 1 (5.9) | 1 (4.4) | ||
Other diseases | 2 (11.8) | 1 (4.4) | ||
Comorbidity &, n (%) | 16 (16.8) | 21 (34.4) | 0.01 |
Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|
OR (95% CI) | p-Value | OR (95% CI) | p-Value | ||
Age, years | 1.0 (1.0–1.0) | 0.21 | 1.0 (1.0–1.0) | 0.98 | |
Age >65 years | 1.0 (0.4–2.2) | 0.96 | - | - | |
Age groups | 0.9 (0.7–1.1) | 0.29 | - | - | |
Males | 1.3 (0.6–2.7) | 0.48 | 1.3 (0.6–2.9) | 0.58 | |
Foreign-born | 1.2 (0.6–2.4) | 0.59 | - | - | |
Geographical area of origin | Italy | 0.8 (0.4–1.7) | 0.59 | - | - |
Africa | 2.6 (1.3–5.3) | 0.009 | 0.8 (0.3–2.6) | 0.76 | |
Eastern Europe | 0.2 (0.1–0.5) | 0.001 | - | - | |
Other countries * | 2.3 (0.9–5.9) | 0.07 | - | - | |
European origin | 0.3 (0.2–0.7) | <0.0001 | 0.2 (0.1–0.6) | 0.004 | |
HIV positivity | 6.0 (1.6–22.8) | 0.008 | 2.3 (0.4–12.1) | 0.33 | |
Hematological diseases | 8.4 (1.0–73.7) | 0.06 | - | - | |
Other causes of immunodepression | 1.0 (0.4–2.5) | 0.91 | - | - | |
Comorbidity & | 2.5 (1.2–5.3) | 0.01 | 3.4 (1.1–10.4) | 0.03 |
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Campogiani, L.; Compagno, M.; Coppola, L.; Malagnino, V.; Maffongelli, G.; Saraca, L.M.; Francisci, D.; Baldelli, F.; Fontana, C.; Grelli, S.; et al. Tuberculosis-Related Hospitalizations in a Low-Incidence Country: A Retrospective Analysis in Two Italian Infectious Diseases Wards. Int. J. Environ. Res. Public Health 2020, 17, 124. https://doi.org/10.3390/ijerph17010124
Campogiani L, Compagno M, Coppola L, Malagnino V, Maffongelli G, Saraca LM, Francisci D, Baldelli F, Fontana C, Grelli S, et al. Tuberculosis-Related Hospitalizations in a Low-Incidence Country: A Retrospective Analysis in Two Italian Infectious Diseases Wards. International Journal of Environmental Research and Public Health. 2020; 17(1):124. https://doi.org/10.3390/ijerph17010124
Chicago/Turabian StyleCampogiani, Laura, Mirko Compagno, Luigi Coppola, Vincenzo Malagnino, Gaetano Maffongelli, Lavinia Maria Saraca, Daniela Francisci, Franco Baldelli, Carla Fontana, Sandro Grelli, and et al. 2020. "Tuberculosis-Related Hospitalizations in a Low-Incidence Country: A Retrospective Analysis in Two Italian Infectious Diseases Wards" International Journal of Environmental Research and Public Health 17, no. 1: 124. https://doi.org/10.3390/ijerph17010124
APA StyleCampogiani, L., Compagno, M., Coppola, L., Malagnino, V., Maffongelli, G., Saraca, L. M., Francisci, D., Baldelli, F., Fontana, C., Grelli, S., Andreoni, M., Sotgiu, G., Saderi, L., & Sarmati, L. (2020). Tuberculosis-Related Hospitalizations in a Low-Incidence Country: A Retrospective Analysis in Two Italian Infectious Diseases Wards. International Journal of Environmental Research and Public Health, 17(1), 124. https://doi.org/10.3390/ijerph17010124