Tuberculosis-Related Hospitalizations in a Low-Incidence Country: A Retrospective Analysis in Two Italian Infectious Diseases Wards

• Published in: International journal of environmental research and public health 2019-12, Vol.17 (1), p.124
• Main Authors: Campogiani, Laura, Compagno, Mirko, Coppola, Luigi, Malagnino, Vincenzo, Maffongelli, Gaetano, Saraca, Lavinia Maria, Francisci, Daniela, Baldelli, Franco, Fontana, Carla, Grelli, Sandro, Andreoni, Massimo, Sotgiu, Giovanni, Saderi, Laura, Sarmati, Loredana
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Africa; Aged; Aged, 80 and over; Asia; Child; Child, Preschool; Drug resistance; Emigrants and Immigrants - statistics & numerical data; Female; Foreign residents; HIV; Hospitalization - statistics & numerical data; Hospitals; Human immunodeficiency virus; Humans; Incidence; Infant; Infant, Newborn; Infections; Infectious diseases; Italy - epidemiology; Localization; Male; Middle Aged; Noncitizens; Patients; Regression analysis; Retrospective Studies; Software; South America; Trends; Tuberculosis; Tuberculosis - epidemiology; Young Adult
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph17010124

In recent years, a decrease in the incidence of tuberculosis (TB) has been recorded worldwide. However, an increase in TB cases has been reported in foreign people living in low-incidence countries, with an increase in extrapulmonary TB (EPTB) in the western region of the world. In the present work, a retrospective study was conducted in two Italian infectious diseases wards to evaluate the clinical characteristics of TB admission in the time period 2013-2017. A significant increase in TB was shown in the study period: 166 (71% males) patients with TB were enrolled, with ~70% coming from outside Italy (30% from Africa, 25% from Europe, and 13% from Asia and South America). Compared to foreign people, Italians were significantly older (71.5 (interquartile range, IQR: 44.5-80.0) vs. 30 (IQR: 24-40) years; < 0.0001) more immunocompromised (48% vs. 17%; < 0.0001), and affected by comorbidities (44% vs. 14%; < 0.0001). EPTB represented 37% of all forms of the disease, and it was more incident in subjects coming from Africa than in those coming from Europe (39.3% vs. 20%, respectively). In logistic regression analysis, being European was protective (odd ratio, OR (95% CI): 0.2 (0.1-0.6); = 0.004) against the development of EPTB forms. In conclusion, an increase in the rate of TB diagnosis was documented in two Italian reference centers in the period 2013-2017, with 39% of EPTB diagnosed in patients from outside Europe.