Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt.
Department of Pharmacy Practice and pharmaceutical sciences, Pharmacy Program, Oman College of Health Sciences, Muscat, Sultanate of Oman.
J Epidemiol Glob Health. 2021 Jun;11(2):238-245. doi: 10.2991/jegh.k.210420.002. Epub 2021 Apr 26.
Little information is available about the etiology, pathophysiology, risk factors, and epidemiologic features of Bone Tuberculosis (Bone-TB). In this work, we present the epidemiological data about the Bone-TB in the Sultanate of Oman.
Retrospectively, we identified and assessed those patients who were diagnosed with Bone-TB between January 2002 and December 2019 at Khoula Hospital. The following data were collected: demographics, clinical presentation, anatomical location, diagnosis, and treatment of the Bone-TB.
During the study period, 115 cases of Bone-TB were diagnosed. Males were affected more than females (57.4% and 42.6%, respectively). About 30% of Bone-TB cases were primary diagnosed in other organs particularly the lungs and then after disseminated to the bone. However, the Bone-TB was detected in hip, leg, hand, shoulder, and skull bones, the most detected Bone-TB was in spine (66% of cases). After vaccination the Bacillus Calmette-Guérin (BCG) strains were identified in the bones of eight babies. Tubercle bacilli were detected by Acid-Fast Stain (AFS) in 59% of cases, and the rest of cases were confirmed using polymerase chain reaction (PCR) tests. There are two used treatment regimens, with 12.4% relapse. The gastrointestinal tract (GIT) disturbances were the most related side effects. The resistance has been detected to pyrazinamide in six cases, rifampicin in three cases, and isoniazid, streptomycin and kanamycin were detected in one case.
The most predominant Bone-TB cases were spine-TB that were mainly disseminated from the lungs. AFS failed to detect tubercle bacilli in 40% of cases. There is no statistical significance in relapse between the used two regimens. The death was predominant among skull-TB cases.
关于骨结核（Bone-TB）的病因、病理生理学、危险因素和流行病学特征的信息很少。在这项工作中，我们介绍了阿曼苏丹国的 Bone-TB 流行病学数据。
我们回顾性地确定并评估了 2002 年 1 月至 2019 年 12 月期间在 Khoula 医院诊断为 Bone-TB 的患者。收集了以下数据：人口统计学特征、临床表现、解剖部位、诊断和治疗。
在研究期间，诊断出 115 例 Bone-TB 病例。男性比女性更容易受影响（分别为 57.4%和 42.6%）。约 30%的 Bone-TB 病例最初是在其他器官（特别是肺部）诊断的，然后扩散到骨骼。然而，在臀部、腿部、手部、肩部和颅骨中发现了最常见的 Bone-TB，其中脊柱的 Bone-TB 占 66%（66%的病例）。在接种卡介苗（BCG）后，在 8 名婴儿的骨骼中发现了卡介苗菌株。59%的病例通过抗酸染色（AFS）检测到结核分枝杆菌，其余病例通过聚合酶链反应（PCR）检测证实。有两种治疗方案，复发率为 12.4%。胃肠道（GIT）紊乱是最相关的副作用。已在 6 例中检测到对吡嗪酰胺的耐药性，在 3 例中检测到对利福平的耐药性，在 1 例中检测到对异烟肼、链霉素和卡那霉素的耐药性。
最主要的 Bone-TB 病例是脊柱-TB，主要是从肺部扩散而来。AFS 未能检测到 40%的病例中的结核分枝杆菌。两种方案的复发率无统计学意义。颅骨-TB 病例中以死亡为主。
