Background
Methods
Setting and participants
Variables and definitions
Microbiology procedures
Statistical methods
Results
Sociodemographic characteristics and comorbidities
Etiological agent | |||
---|---|---|---|
Characteristic |
M. bovis
(n = 161) |
M. tuberculosis
(n = 372) |
p
a
|
Age, years, median (IQR) | 38 (29–52) | 49 (33–64) | <0.001b |
Sex (female) | 66/161 (40.9) | 164/372 (44) | 0.5 |
Healthcare worker | 5/151 (3.3) | 19/360 (5.2) | 0.33 |
Farm worker | 5/151 (3.3) | 26/360 (7.2) | 0.09 |
Low socioeconomic status | 17/161 (10.5) | 62/372 (16.6) | 0.068 |
BCG-vaccinated | 82/118 (69.4) | 179/261 (68.5) | 0.86 |
Contact with TB-infected people | 18/139 (12.9) | 67/335 (20) | 0.069 |
Resides in a non-accredited zone for bovine-TB eradicationc | 140/159 (88) | 303/370 (81.8) | 0.078 |
Alcohol intake ≥ 40 g/day | 9/152 (5.9) | 36/354 (10.1) | 0.12 |
Smoker (present) | 71/153 (46.4) | 147/356 (41.2) | 0.28 |
HIV coinfection | 43/161 (26.7) | 79/372 (21.2) | 0.16 |
CD4 count ≤200 cells/mm3 | 31/35 (88.5) | 60/67 (89.5) | 0.87 |
Diabetes mellitus | 23/161 (14.2) | 84/372 (22.5) | 0.028 |
Connective tissue diseased | 29/161 (18) | 43/372 (11.5) | 0.045 |
Solid organ transplant recipient | 4/161 (2.4) | 8/372 (2.1) | 0.81 |
Charlson comorbidity index ≥3 | 72/161 (44.7) | 150/372 (40.3) | 0.34 |
Previous TB | 2/161 (1.2) | 14/372 (3.7) | 0.11 |
Glucocorticoid usee | 46/161 (28.5) | 54/372 (14.5) | <0.001 |
Clinical and microbiological characteristics
Etiological agent | |||
---|---|---|---|
Characteristic |
M. bovis
(n = 161) |
M. tuberculosis
(n = 372) |
p
a
|
Anatomical site of isolation | |||
Pulmonary | 58/161 (36) | 196/372 (52.6) | <0.001 |
Extrapulmonary | 67/161 (41.6) | 112/372 (30.1) | 0.01 |
Pulmonary and Extrapulmonary | 36/161 (22.3) | 64/372 (17.2) | 0.16 |
Primary site of isolation (Restricted to pulmonary cases with and extrapulmonary involvements casesb) | |||
Abdominalc | 7/36 (19.4) | 22/64 (34.3) | 0.11 |
Genitourinary | 16/36 (44.4) | 22/64 (34.3) | 0.31 |
Central Nervous System | 10/36 (27.7) | 9/64 (14) | 0.093 |
Lymph node | 0/36 (0) | 1/64 (1.5) | – |
Skin, joint, bone, and soft tissue | 3/36 (8.3) | 2/64 (3.1) | 0.25 |
Blood, bone marrow, liver, and spleen | 0/36 (0) | 8/64 (12.5) | – |
Primary site of isolation (Restricted to extrapulmonary casesd) | |||
Abdominalc | 22/67 (32.8) | 12/112 (10.7) | <0.001 |
Genitourinary | 9/67 (13.4) | 26/112 (23.2) | 0.11 |
Central Nervous System | 14/67 (20.9) | 17/112 (15.1) | 0.32 |
Lymph node | 15/67 (22.3) | 37/112 (33) | 0.12 |
Skin, joint, bone, and soft tissue | 4/67 (5.9) | 13/112 (11.6) | 0.21 |
Blood, bone marrow, liver, and spleen | 3/67 (4.4) | 7/112 (6.2) | 0.61 |
Primary site of isolation (Restricted to pulmonary cases with and extrapulmonary involvement casesd) | |||
Abdominalc | 7/36 (19.4) | 22/64 (34.3) | 0.11 |
Genitourinary | 16/36 (44.4) | 22/64 (34.3) | 0.31 |
Central Nervous System | 10/36 (27.7) | 9/64 (14) | 0.093 |
Lymph node | 0/36 (0) | 1/64 (1.5) | – |
Skin, joint, bone, and soft tissue | 3/36 (8.3) | 2/64 (3.1) | 0.25 |
Blood, bone marrow, liver, and spleen | 0/36 (0) | 8/64 (12.5) | – |
Symptom onset to diagnosis, days, median (IQR) | 63 (32–154) | 90 (34–197) | 0.089e |
Presenting symptoms | |||
Fever | 127/159 (79.8) | 254/364 (69.7) | 0.019 |
Weight loss | 72/159 (45.2) | 181/364 (49.7) | 0.38 |
Cough | 60/159 (37.7) | 195/364 (53.5) | 0.001 |
Haemoptysis | 5/159 (3.1) | 29/364 (7.9) | 0.039 |
Gastrointestinalf | 71/159 (44.6) | 117/364 (32.3) | 0.007 |
Neurological | 30/159 (18.8) | 63/364 (17.3) | 0.67 |
Genitourinary | 10/159 (6.2) | 29/364 (7.9) | 0.49 |
Primary multidrug resistanceg | 1/161 (0.6) | 6/372 (1.6) | 0.35 |
Mean TST induration, mm, (IQR) | 9.6 (0–18) | 14 (0–25) | 0.02e |
≥5 mm | 30/76 (39.4) | 91/172 (52.9) | 0.051 |
≥10 mm | 29/76 (38.1) | 91/172 (52.9) | 0.032 |
≥15 mm | 23/76 (30.2) | 79/172 (45.9) | 0.021 |
Characteristics of pulmonary disease
Etiological agent | |||
---|---|---|---|
Characteristic |
M. bovis
(n = 94) |
M. tuberculosis
(n = 260) |
p
b
|
Age, years, median (IQR) | 39 (30–51) | 46 (30–64) | 0.0053c |
Sex (female) | 33/94 (35.1) | 99/260 (38) | 0.61 |
Healthcare worker | 3/88 (3.4) | 15/255 (5.8) | 0.37 |
Farm worker | 2/88 (2.2) | 22/255 (8.6) | 0.044 |
Low socioeconomic status | 9/94 (9.5) | 49/260 (18.8) | 0.037 |
BCG-vaccinated | 42/63 (66.6) | 130/186 (69.8) | 0.63 |
Contact with TB-infected people | 11/80 (13.7) | 48/235 (20.4) | 0.18 |
Resides in high-prevalence region of bovine TBd | 83/93 (89.2) | 209/259 (80.6) | 0.06 |
Alcohol intake ≥ 40 g/dayay | 5/89 (5.6) | 30/251 (11.9) | 0.09 |
Unpasteurized dairy products consumption | 2/10 (20) | 8/17 (47) | 0.16 |
Smoker (present) | 50/89 (56.1) | 103/253 (40.7) | 0.012 |
HIV coinfection | 26/94 (27.6) | 63/260 (24.2) | 0.51 |
CD4 count ≤200 cells/mm3 | 20/21 (95.2) | 46/51 (90.2) | 0.48 |
Diabetes mellitus | 20/94 (21.2) | 60/260 (23) | 0.72 |
Connective tissue diseasee | 17/94 (18) | 28/260 (10.7) | 0.068 |
Charlson comorbidity index ≥3 | 46/94 (48.9) | 121/260 (46.5) | 0.69 |
Glucocorticoid usef | 25/94 (26.6) | 37/260 (14.2) | 0.007 |
Symptom onset to diagnosis, days, median (IQR) | 62 (35–131) | 80 (33–182) | 0.15g |
Presenting symptoms | |||
Fever | 75/93 (80.6) | 194/255 (76) | 0.36 |
Weight loss | 48/93 (51.6) | 137/255 (53.7) | 0.72 |
Cough | 47/93 (50.5) | 171/255 (67) | 0.005 |
Haemoptysis | 5/93 (5.3) | 26/255 (10.2) | 0.16 |
Dyspnoea | 25/93 (26.8) | 81/255 (31.7) | 0.38 |
Chest radiography pattern | |||
Normal | 13/79 (16.4) | 19/242 (7.8) | 0.027 |
Cavitary | 9/79 (11.3) | 33/242 (13.6) | 0.6 |
Miliary | 30/79 (37.9) | 63/242 (26) | 0.042 |
Pleural effusion | 17/79 (21.5) | 40/242 (16.5) | 0.31 |
Consolidation | 13/79 (16.4) | 65/242 (26.8) | 0.061 |
Nodule | 1/79 (1.2) | 23/242 (9.5) | 0.013h |
Interstitial | 1/79 (1.2) | 10/242 (4.1) | 0.3h |
Respiratory sample positive smear | 39/88 (44.3) | 132/252 (52.3) | 0.19 |
Multivariate analysis
All cases | Pulmonary casesa | |
---|---|---|
Factor | Adjusted OR (95 % CI) | Adjusted OR (95 % CI) |
Age | 0.97 (0.95–0.98) | 0.97 (0.96–0.99) |
Resides in non-accredited zone for bovine-TB eradicationb | 1.68 (0.94–3.0) | 1.67 (0.77–3.62) |
Low socioeconomic status | 0.52 (0.28–0.97) | 0.48 (0.21–1.1) |
Glucocorticoid usec | 2.27 (1.42–3.63) | 2.41 (1.30–4.46) |
Extrapulmonary disease | 1.80 (1.21–2.69) | 1.61 (0.93–2.80) |
Smoker (present) | 1.94 (1.15–3.27) |