ArticleJournal of the International AIDS Society2019
Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study.
Article in Journal of the International AIDS Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis.The Cochrane database of systematic reviews · 2021Pooled it
- Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Gastrointestinal tuberculosis: A systematic review of epidemiology, presentation, diagnosis and treatment.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationPooled it
- Ultrasononography in Managing Extrapulmonary Tuberculosis: A Randomized, Controlled, Parallel, Superiority, Open-Label Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Comparison of the treatment outcomes and identification of the risk factors associated with unfavorable outcomes among extra pulmonary and pulmonary tuberculosis patients under NTEP.BMC infectious diseases · 2026Article
- Diagnostic Accuracy of Sonographic Signs of Extrapulmonary Tuberculosis and Treatment Response Monitoring in HIV-Positive and -Negative Populations.The ultrasound journal · 2026Article
- Hiding in Plain Sight: A Case of Intestinal Tuberculosis Masquerading as Benign Lower GI Bleeding.Case reports in gastrointestinal medicine · 2026Article
- Epidemiology and clinicodemographic features of microbiologically confirmed and presumptive extrapulmonary tuberculosis in Ethiopia: a multicenter study.IJID regions · 2025Article
- Distribution of extrapulmonary tuberculosis in CBNAAT samples received in a tertiary care hospital - A record-based study.Journal of family medicine and primary care · 2024Article
- Interferon-gamma release assays as a tool for differential diagnosis of gastrointestinal tuberculosis.World journal of clinical cases · 2024Article
- Diagnostic Yield of Urine Xpert MTB/RIF Ultra in Adults With Suspected Extrapulmonary Tuberculosis.Open forum infectious diseases · 2024Article
- Mortality among extrapulmonary tuberculosis patients in the HIV endemic setting: lessons from a tertiary level hospital in Mbeya, Tanzania.Scientific reports · 2024Article
- Comparing the cost-effectiveness of the MPT64-antigen detection test to Xpert MTB/RIF and ZN-microscopy for the diagnosis of Extrapulmonary Tuberculosis: An economic evaluation modelling study.PLOS global public health · 2024Article
- Diagnostic Performance of Different Laboratory Methods for the Detection of Extrapulmonary Tuberculosis.Microorganisms · 2023Article
- Article
- The clinical presentation and detection of tuberculosis during pregnancy and in the postpartum period in low- and middle-income countries: A systematic review and meta-analysis.PLOS global public health · 2023Article
- Performance of Xpert MTB/RIF for Diagnosis of Tuberculosis in HIV-Infected People in China: A Retrospective, Single-Center Study.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Isolated Tuberculous Myositis: A Systematic Review and Multicenter Cases.Journal of rheumatic diseases · 2022Article
- Host-directed therapies in pulmonary tuberculosis: Updates on anti-inflammatory drugs.Frontiers in medicine · 2022Review
- Improved diagnosis of extrapulmonary tuberculosis in adults with and without HIV in Mbeya, Tanzania using the MPT64 antigen detection test.PLOS global public health · 2022Article
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Authors and funding
14 authors.
Funding
Abstract
introductionExtrapulmonary tuberculosis (EPTB) is difficult to confirm bacteriologically and requires specific diagnostic capacities. Diagnosis can be especially challenging in under-resourced settings. We studied diagnostic modalities and clinical outcomes of EPTB compared to pulmonary tuberculosis (PTB) among HIV-positive adults in antiretroviral therapy (ART) programmes in low- and middle-income countries (LMIC).
methodsWe collected data from HIV-positive TB patients (≥16 years) in 22 ART programmes participating in the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium in sub-Saharan Africa, Asia-Pacific, and Caribbean, Central and South America regions between 2012 and 2014. We categorized TB as PTB or EPTB (EPTB included mixed PTB/EPTB). We used multivariable logistic regression to assess associations with clinical outcomes. RESULTS AND DISCUSSION: We analysed 2695 HIV-positive TB patients. Median age was 36 years (interquartile range (IQR) 30 to 43), 1102 were female (41%), and the median CD4 count at TB treatment start was 114 cells/μL (IQR 40 to 248). Overall, 1930 had PTB (72%), and 765 EPTB (28%). Among EPTB patients, the most frequently involved sites were the lymph nodes (24%), pleura (15%), abdomen (11%) and meninges (6%). The majority of PTB (1123 of 1930, 58%) and EPTB (582 of 765, 76%) patients were diagnosed based on clinical criteria. Bacteriological confirmation (using positive smear microscopy, culture, Xpert MTB/RIF, or other nucleic acid amplification tests result) was obtained in 897 of 1557 PTB (52%) and 183 of 438 EPTB (42%) patients. EPTB was not associated with higher mortality compared to PTB (adjusted odd ratio (aOR) 1.0, 95% CI 0.8 to 1.3), but TB meningitis was (aOR 1.9, 95% CI 1.0 to 3.1). Bacteriological confirmation was associated with reduced mortality among PTB patients (aOR 0.7, 95% CI 0.6 to 0.8) and EPTB patients (aOR 0.3 95% CI 0.1 to 0.8) compared to TB patients with a negative test result.
conclusionsDiagnosis of EPTB and PTB at ART programmes in LMIC was mainly based on clinical criteria. Greater availability and usage of TB diagnostic tests would improve the diagnosis and clinical outcomes of both EPTB and PTB.
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