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

• Main Authors: Laura Campogiani, Mirko Compagno, Luigi Coppola, Vincenzo Malagnino, Gaetano Maffongelli, Lavinia Maria Saraca, Daniela Francisci, Franco Baldelli, Carla Fontana, Sandro Grelli, Massimo Andreoni, Giovanni Sotgiu, Laura Saderi, Loredana Sarmati
• Format: Article
• Language: English
• Published: MDPI AG 2019-12-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: tuberculosis; pulmonary tuberculosis; extrapulmonary tuberculosis; foreign people
• Online Access: https://www.mdpi.com/1660-4601/17/1/124

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&#8722;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&#8722;80.0) vs. 30 (IQR: 24&#8722;40) years; <i>p</i> &lt; 0.0001) more immunocompromised (48% vs. 17%; <i>p</i> &lt; 0.0001), and affected by comorbidities (44% vs. 14%; <i>p</i> &lt; 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&#8722;0.6); <i>p</i> = 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&#8722;2017, with 39% of EPTB diagnosed in patients from outside Europe.