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

Published online

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Lapadula, G; Zanini, F; Codecasa, L; Franzetti, F; Ferrarese, M; Carugati, M; Mazzola, E; Schiroli, C; Motta, D; Iemmi, D; Gori, A

Published Date

  • 2013

Published In

Volume / Issue

  • 5 / 1

Start / End Page

  • e2013071 -

PubMed ID

  • 24363886

Pubmed Central ID

  • 24363886

International Standard Serial Number (ISSN)

  • 2035-3006

Digital Object Identifier (DOI)

  • 10.4084/MJHID.2013.071

Language

  • eng

Conference Location

  • Italy