Evidence map›Paper›PMID 27137870›Full record

ArticlePublic health2016

High proportion of extrapulmonary tuberculosis in a low prevalence setting: a retrospective cohort study.

J N Sama, N Chida, R M Polan, J Nuzzo, K Page, M Shah

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Public health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Epidemiology of extrapulmonary tuberculosis, Alameda County, California, 2010-2021.Journal of clinical tuberculosis and other mycobacterial diseases · 2026
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  13. Post-TB health and wellbeing.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

J N SamaThe Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, USA. Electronic address: jsama1@jhu.edu.
N ChidaThe Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, USA. Electronic address: Nchida1@jhmi.edu.
R M PolanThe Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, USA. Electronic address: rpolan1@jhmi.edu.
J NuzzoJohns Hopkins University School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; UPMC Center for Health Security, 621 East Pratt Street, Baltimore, MD 21202, USA. Electronic address: jnuzzo1@jhu.edu.
K PageThe Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, USA; Baltimore City Health Department, 620 North Caroline Street, Baltimore, MD 21205, USA. Electronic address: kpage2@jhmi.edu.
M ShahThe Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, USA; Baltimore City Health Department, 620 North Caroline Street, Baltimore, MD 21205, USA. Electronic address: mshah28@jhmi.edu.
Johns Hopkins University · USJohns Hopkins Medicine · USJohns Hopkins Center for Health Security · US

Funding

RESEARCH TRAINING IN MICROBIAL DISEASEST32AI007291 · NIAID · JOHNS HOPKINS UNIVERSITY · PI JOEL N BLANKSON, Sara Elizabeth Cosgrove · 1986 to 2026
$9.1M
Implementation Science Approaches for Novel TB Diagnostics in HIV Prevalent AreasK23AI089259 · NIAID · JOHNS HOPKINS UNIVERSITY · PI SHAH, MAUNANK · 2011 to 2015
$681k
NIAID NIH HHS K23 AI089259NIAID NIH HHS T32 AI007291
6 · The paper itself

Abstract

objectivesThe proportion of extrapulmonary tuberculosis (EPTB) cases in the United States (US) has been rising due to a slower rate of decline in EPTB compared to pulmonary tuberculosis (PTB). The purpose of this study was to characterise the clinical and treatment differences between EPTB and PTB patients, and identify patient factors associated with EPTB. STUDY

designWe performed a retrospective cohort study of active tuberculosis (TB) cases treated at the Baltimore City Health Department between 2008 and 2013.

methodsWe categorised patients as having 'only PTB' (infection in the lung parenchyma), 'EPTB/PTB' (infection in the lung and an additional site), and 'only EPTB' (infection not involving the lung). Pearson's chi-squared tests were used to evaluate categorical variables and compare clinical and demographic differences between only PTB, only EPTB, and EPTB/PTB patients. Student t-tests and one-way analysis of variance tests were utilised to assess continuous variables and to compare treatment differences.

resultsOne hundred and sixty-three patients were treated for TB; 39.3% had some form of EPTB (either EPTB/PTB or only EPTB). There was no difference found between EPTB, PTB, and EPTB/PTB patients with respect to HIV status, gender, race, foreign-born status, or mean age. Patients with only EPTB were less likely than patients with some form of PTB (only PTB or EPTB/PTB) to present with cough (30.4% vs 61.5%; P < 0.001), night sweats (10.9% vs 39.3%; P < 0.001), and weight loss (28.3% vs 47.9%; P = 0.023). Patients with some form of EPTB were also more likely to be hospitalised postdiagnosis compared to patients with only PTB (39.1% vs 20.2%; P = 0.009), and to have longer mean durations of treatment (37.9 weeks [SD = 11.1] vs 31.8 weeks [SD = 8.1]; P < 0.001).

conclusionsEPTB patients present with atypical symptoms, undergo prolonged treatment, and experience increased hospitalisations. In order to improve diagnostic algorithms and treatment modalities, EPTB must be further characterised.

Indexed as

AdolescentAdultAgedBaltimoreChildChild, PreschoolFemaleHumansInfantInfant, NewbornMaleMiddle AgedPrevalenceRetrospective StudiesRisk FactorsTuberculosisBaltimore cityExtrapulmonary tuberculosisForeign bornTuberculosis

Identifiers

PMID27137870
PMCPMC5012930
OpenAlexW2343719388

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.