Influence of Hospitalization upon Diagnosis on the Risk of Tuberculosis Clustering.

dc.contributor.author

Lapadula, Giuseppe

dc.contributor.author

Zanini, Fabio

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Codecasa, Luigi

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Franzetti, Fabio

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Ferrarese, Maurizio

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Carugati, Manuela

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Mazzola, Ester

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Schiroli, Consuelo

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Motta, Davide

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Iemmi, Diego

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Gori, Andrea

dc.date.accessioned

2024-01-25T16:14:16Z

dc.date.available

2024-01-25T16:14:16Z

dc.date.issued

2013-01

dc.description.abstract

Setting

Culture-positive tuberculosis (TB) diagnosed in the metropolitan area of Milan (Italy) over a 5-year period (1995-1999).

Objective

To assess the impact of short-course hospitalization upon diagnosis on the overall risk of TB clustering.

Design

Restriction fragment length polymorphism profiles with a similarity of 100% defined a cluster. Uni- and multivariable logistic regression models were performed to assess factors associated with clustering.

Results

Among 1139 patients, 392 (34.4%) were hospitalized before or soon after diagnosis, 405 (35.6%) received domiciliary treatment since the diagnosis and 392 (30%) had no information about initial clinical management. One hundred fifteen molecular clusters involving 363 patients were identified. Using multivariable analysis, hospitalization was not significantly associated with clustering (OR 1.06, 95%CI 0.75-1.50, p=0.575). Subjects aged >65 years old (OR 0.60; 95CI%:0.37-0.95; p=0.016) and non-Italian born patients (OR 0.56; 95%CI:0.41-0.76; p<0.001) were running a lower risk of clustering. Conversely, HIV co-infected patients (OR 1.88, 95%CI:1.20-2.95, p=0.006) and those with MDR TB (OR 2.50, 95%CI:1.46-4.25, p=0.001) were significantly more likely to be involved in clusters.

Conclusion

In our cohort, domiciliary treatment was not associated with TB clustering. Expanding domiciliary treatment upon diagnosis appears as an advisable measure to reduce unnecessary costs for the health care system.
dc.identifier

mjhid-5-1-e2013071

dc.identifier.issn

2035-3006

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2035-3006

dc.identifier.uri

https://hdl.handle.net/10161/29822

dc.language

eng

dc.publisher

Institute of Hematology, Catholic University

dc.relation.ispartof

Mediterranean journal of hematology and infectious diseases

dc.relation.isversionof

10.4084/mjhid.2013.071

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.title

Influence of Hospitalization upon Diagnosis on the Risk of Tuberculosis Clustering.

dc.type

Journal article

duke.contributor.orcid

Carugati, Manuela|0000-0002-3187-5905

pubs.begin-page

e2013071

pubs.issue

1

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

pubs.organisational-group

Medicine

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Medicine, Infectious Diseases

pubs.publication-status

Published

pubs.volume

5

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