Epidemiology of Peripheral Lymph Node Tuberculosis and Genotyping of XXXX Strains: A Case-Control Study.

@entity1 @entity8118
BACKGROUND: This study examined potential risk factors of lymph node tuberculosis (LNTB), including phylogenetic lineages of @entity8118 (MTB), in comparison to pulmonary tuberculosis (PTB) in a setting with an ethnically diverse population. METHODS: We conducted a case-control study at a major tuberculosis clinic in Sydney, Australia, which included all @entity1 with peripheral LNTB seen at the clinic between 2000 and 2012. Controls were randomly selected @entity1 with PTB seen at the same clinic during the study period. Epidemiological data were extracted from the hospital electronic database and medical records. Associations between LNTB and age, sex, ethnicity, comorbidities and phylogenetic lineages of MTB in comparison to PTB were examined using logistic regression in univariate and multivariate analyses. RESULTS: There were 212 cases with LNTB and 424 randomly selected controls with PTB. Among @entity1 with LNTB, 74% were female and the mean age (standard deviation, SD) was 42 (16) years. Among @entity1 with PTB, 43% were female and the mean age was 44 (22) years. Females, 45 to 64-year-olds and Southern Asians had an increased risk for LNTB (OR 3.13, 95% CI 2.10-4.67; OR 2.50, 95% CI 1.29-4.84; OR 3.95, 95% CI 1.54-10.12 respectively). @entity1 with diabetes were at a higher risk of PTB (OR 0.40, 95% CI 0.19 - 0.83 for LNTB). A subset analysis showed that @entity1 infected with the East African Indian strain of MTB were more likely to develop LNTB (OR 10.07, 95% CI 2.37-42.77). CONCLUSIONS: An increased risk for LNTB (but still lower rates than for PTB) was found among females, @entity1 aged 45 to 64 years and @entity1 born in Southern Asia. An increased risk for PTB was found among @entity1 with diabetes. The East African Indian strain of MTB was significantly associated with a higher likelihood of LNTB compared to other MTB strains.
