Rl. Cowie et Jw. Sharpe, EXTRA-PULMONARY TUBERCULOSIS - A HIGH-FREQUENCY IN THE ABSENCE OF HIV-INFECTION, The international journal of tuberculosis and lung disease, 1(2), 1997, pp. 159-162
SETTING: A tuberculosis centre for the diagnosis, management and contr
ol of all tuberculosis in a region in Western Canada with a population
of approximately 1.2 million. OBJECTIVE: To measure the proportion of
cases of extra-pulmonary tuberculosis in relation to country of birth
, age and gender of the subject. DESIGN: A prospective study of all pa
tients with tuberculosis diagnosed during a five-year period, 1990-199
4. Information relating to age, country of birth and details relating
to their tuberculosis were all gathered and stored on a computerised t
uberculosis register. RESULTS: A total of 351 patients with tuberculos
is were diagnosed during the five-year period. Extra-pulmonary tubercu
losis, defined as disease which, with the exception of miliary tubercu
losis, was not associated with lung involvement, was diagnosed in 160
(46%) of the patients. The incidence of extra-pulmonary tuberculosis,
especially lymph node disease, tended to be higher in younger patients
but was significantly higher in immigrants from Asia in whom the majo
rity (61%) presented with extra-pulmonary disease. Less than 2% of the
subjects in this study were infected with the human immunodeficiency
virus (HIV). CONCLUSION: Extra-pulmonary tuberculosis accounted for ap
proximately half of the cases of tuberculosis in a western Canadian tu
berculosis centre. This high frequency of extra-pulmonary disease was
not attributable to HIV infection.