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Extrapulmonary tuberculosis, human immunodeficiency virus, and foreign birth in North Carolina, 1993 - 2006.

dc.contributor.author Kipp, Aaron M
dc.contributor.author Stout, Jason E
dc.contributor.author Hamilton, Carol Dukes
dc.contributor.author Van Rie, Annelies
dc.coverage.spatial England
dc.date.accessioned 2015-12-03T20:39:20Z
dc.date.issued 2008-04-04
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/18394166
dc.identifier 1471-2458-8-107
dc.identifier.uri https://hdl.handle.net/10161/11068
dc.description.abstract BACKGROUND: The proportion of extrapulmonary tuberculosis (EPTB) reported in the United States has been gradually increasing. HIV infection and foreign birth are increasingly associated with tuberculosis and understanding their effect on the clinical presentation of tuberculosis is important. METHODS: Case-control study of 6,124 persons with tuberculosis reported to the North Carolina Division of Public health from January 1, 1993 to December 31, 2006. Multivariate logistic regression was used to obtain adjusted odds ratios measuring the associations of foreign birth region and US born race/ethnicity, by HIV status, with EPTB. RESULTS: Among all patients with tuberculosis, 1,366 (22.3%) had EPTB, 563 (9.2%) were HIV co-infected, and 1,299 (21.2%) were foreign born. Among HIV negative patients, EPTB was associated with being foreign born (adjusted ORs 1.36 to 5.09, depending on region of birth) and with being US born, Black/African American (OR 1.84; 95% CI 1.42, 2.39). Among HIV infected patients, EPTB was associated with being US born, Black/African American (OR 2.60; 95% CI 1.83, 3.71) and with foreign birth in the Americas (OR 5.12; 95% CI 2.84, 9.23). CONCLUSION: Foreign born tuberculosis cases were more likely to have EPTB than US born tuberculosis cases, even in the absence of HIV infection. Increasing proportions of foreign born and HIV-attributable tuberculosis cases in the United States will likely result in a sustained burden of EPTB. Further research is needed to explore why the occurrence and type of EPTB differs by region of birth and whether host genetic and/or bacterial variation can explain these differences in EPTB.
dc.language eng
dc.publisher Springer Science and Business Media LLC
dc.relation.ispartof BMC Public Health
dc.relation.isversionof 10.1186/1471-2458-8-107
dc.subject AIDS-Related Opportunistic Infections
dc.subject Case-Control Studies
dc.subject Emigration and Immigration
dc.subject Female
dc.subject HIV Infections
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject North Carolina
dc.subject Odds Ratio
dc.subject Tuberculosis
dc.title Extrapulmonary tuberculosis, human immunodeficiency virus, and foreign birth in North Carolina, 1993 - 2006.
dc.type Journal article
duke.contributor.id Stout, Jason E|0135823
duke.contributor.id Hamilton, Carol Dukes|0045720
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/18394166
pubs.begin-page 107
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Infectious Diseases
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 8
dc.identifier.eissn 1471-2458
duke.contributor.orcid Stout, Jason E|0000-0002-6698-8176


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