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Review

Diagnosis of Osteoarticular Tuberculosis: Perceptions, Protocols, Practices, and Priorities in the Endemic and Non-Endemic Areas of the World—A WAIOT View

1
PD Hinduja Hospital, Mahim, Mumbai 400016, India
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ENABLE International Centre for Paediatric Musculoskeletal Care, Mumbai 400016, India
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Dr. Agashe’s Maternity and Surgical Nursing Home, 116 Bazar ward, MN, Road Kurla, Mumbai 400070, India
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Department of Orthopaedics, ASCOMS and Hospital, J and K, Jammu 180017, India
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Studio Medico Associato Cecca-Romanò, 20121 Milano, Italy
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Clinical Microbiology, University of Milan, 20100 Milan, Italy
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Hull University Teaching Hospitals, Anlaby Road, Hull HU3 2JZ, UK
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Zerktouni Orthopaedic Clinic, Casablanca 20000, Morocco
*
Author to whom correspondence should be addressed.
Microorganisms 2020, 8(9), 1312; https://doi.org/10.3390/microorganisms8091312
Received: 6 July 2020 / Revised: 18 August 2020 / Accepted: 23 August 2020 / Published: 28 August 2020
(This article belongs to the Special Issue Biofilm Implant Related Infections)
There has been a major resurgence of tuberculosis (TB) and drug-resistant tuberculosis in the last few decades. Although it has been brought under control in most Western countries, it is still a major cause of death in endemic regions like India. Osteoarticular tuberculosis (OA TB) forms a small proportion of the total cases of tuberculosis. Perceptions and practices of orthopedic surgeons are entirely different in endemic and non-endemic regions around the world, due to the vast difference in exposure. Literature from endemic areas puts stress on clinico-radiological diagnosis and empirical anti-tubercular treatment (ATT). Such practices, although non-invasive, simple to implement, and economical, carry a significant risk of missing TB mimics and developing drug resistance. However, OA TB is still perceived as a “diagnostic enigma” in non-endemic regions, leading to a delay in diagnosis. Hence, a high index of suspicion, especially in a high-risk population, is needed to improve the diagnosis. Evolving drug resistance continues to thwart efforts to control the disease globally. This review article discusses the perceptions and practices in different parts of the world, with India as an example of the endemic world, and lays down priorities for overcoming the challenges of diagnosing osteoarticular TB. View Full-Text
Keywords: osteoarticular tuberculosis; endemic; clinico-radiological diagnosis; GeneXpert; culture; drug sensitivity; drug-resistant tuberculosis osteoarticular tuberculosis; endemic; clinico-radiological diagnosis; GeneXpert; culture; drug sensitivity; drug-resistant tuberculosis
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MDPI and ACS Style

Agashe, V.M.; Johari, A.N.; Shah, M.; Anjum, R.; Romano, C.; Drago, L.; Sharma, H.K.; Benzakour, T. Diagnosis of Osteoarticular Tuberculosis: Perceptions, Protocols, Practices, and Priorities in the Endemic and Non-Endemic Areas of the World—A WAIOT View. Microorganisms 2020, 8, 1312. https://doi.org/10.3390/microorganisms8091312

AMA Style

Agashe VM, Johari AN, Shah M, Anjum R, Romano C, Drago L, Sharma HK, Benzakour T. Diagnosis of Osteoarticular Tuberculosis: Perceptions, Protocols, Practices, and Priorities in the Endemic and Non-Endemic Areas of the World—A WAIOT View. Microorganisms. 2020; 8(9):1312. https://doi.org/10.3390/microorganisms8091312

Chicago/Turabian Style

Agashe, Vikas M.; Johari, Ashok N.; Shah, Mudit; Anjum, Rashid; Romano, Carlo; Drago, Lorenzo; Sharma, Hemant K.; Benzakour, Thami. 2020. "Diagnosis of Osteoarticular Tuberculosis: Perceptions, Protocols, Practices, and Priorities in the Endemic and Non-Endemic Areas of the World—A WAIOT View" Microorganisms 8, no. 9: 1312. https://doi.org/10.3390/microorganisms8091312

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