Table 2.
Demographic and Clinical Characteristics Associated With Laboratory-Confirmed Tuberculosis Among Cases Admitted With Severe Respiratory Illness of Any Duration and Tested for Tuberculosis at Two Sites in South Africa, 2012–2014 (N = 2097)
| Variables |
Tuberculosis Negative
n/N (%) |
Tuberculosis Positive
n/N (%) |
Univariate Analysis | Multivariable Analysis | ||
|---|---|---|---|---|---|---|
| OR (95% CI) | P Value | OR (95% CI) | P Value | |||
| Age | ||||||
| 15–24 | 107/1504 (7) | 63/593 (11) | Reference | Reference | ||
| 25–44 | 780/1504 (52) | 365/593 (62) | 0.8 (0.6–1.1) | .179 | 0.7 (0.5–1.1) | .114 |
| 45–64 | 475/1504 (32) | 144/593 (24) | 0.5 (0.4–0.7) | <.001 | 0.6 (0.4–0.9) | .007 |
| 65+ | 142/1504 (9) | 21/593 (3) | 0.3 (0.1–0.4) | <.001 | 0.3 (0.1–0.5) | <.001 |
| Female gender | 801/1503 (53) | 397/593 (51) | 0.9 (0.7–1.1) | .295 | ||
| Klerksdorp Tshepong | 991/1504 (66) | 397/593 (67) | 1.04 (0.9–1.3) | .645 | ||
| Duration of symptoms >14 days | 908/1504 (60) | 460/593 (76) | 2.3 (1.8–2.8) | <.001 | 1.6 (1.2–2.0) | .001 |
| History of cough (any duration) | 1416/1503 (94) | 564/593 (95) | 1.2 (0.8–1.8) | .419 | ||
| Chronic cough >14 days | 833/1503 (55) | 833/592 (73) | 2.2 (1.8–2.7) | <.001 | ||
| History of fever | 544/1493 (37) | 239/590 (41) | 1.2 (0.9–1.4) | .084 | ||
| Night sweats | 927/1503 (62) | 412/591 (70) | 1.4 (1.2–1.8) | <.001 | ||
| Underlying medical conditiona | 161/1503 (11) | 27/593 (5) | 0.4 (0.3–0.6) | <.001 | ||
| Diabetes | 48/1502 (3) | 12/593 (2) | 0.6 (0.3–1.2) | .151 | ||
| History of TB treatmente | 142/1499 (9) | 68/589 (28) | 1.2 (0.9–1.7) | .157 | ||
| HIV infected | 1014/1355 (75) | 424/522 (81) | 1.5 (1.1–1.9) | .003 | ||
| Worked in minec | 173/1484 (12) | 68/583 (12) | 1.0 (0.7–1.3) | .997 | ||
| History of smokingb | 281/1488 (19) | 113/586 (19) | 1.0 (0.8–1.3) | .835 | ||
| History of alcoholb | 374/1489 (25) | 128/586 (22) | 0.8 (0.6–1.0) | .117 | ||
| Influenza-positive | 89/1471 (6) | 24/582 (4) | 0.7 (0.4–1.06) | .086 | ||
| Pneumococcal coinfectiond | 212/1366 (16) | 42/535 (8) | 0.5 (0.3–0.7) | <.001 | 0.6 (0.4–0.9) | .024 |
| Viral coinfection | 419/1471 (28) | 169/582 (29) | 1.03 (0.8–1.3) | .802 | ||
| Invasive bacterial infection on cultureg | 7/251 (3) | 2/122 (2) | 0.6 (0.1–2.8) | .502 | ||
| Required oxygen | 547/1445 (38) | 171/584(29) | 0.7 (0.5–0.8) | <.001 | 0.7 (0.6–0.9) | .005 |
| Antibiotics on admission | 1421/1468 (97) | 554/588 (94) | 0.5 (0.3–0.8) | .007 | ||
| TB treatment startedf | 470/1371 (34) | 422/547 (77) | 6.5 (5.1–8.1) | <.001 | 5.6 (4.-7.2) | <.001 |
| Duration of hospitalization | ||||||
| <3 days | 247/1364 (18) | 102/554 (18) | Reference | |||
| 3–7 days | 557/1364 (41) | 248/554 (45) | 1.1 (0.8–1.4) | .592 | ||
| 8+ days | 560/1364 (41) | 204/554 (37) | 0.9 (0.7–1.2) | .382 | ||
| Died during admission | 152/1423 (11) | 67/578 (12) | 1.1 (0.8–1.5) | .555 | ||
Bold indicates significant variables.
Abbreviations: CI, confidence interval; HIV, human immunodeficiency virus; OR, odds ratio; PCR, polymerase chain reaction; TB, tuberculosis.
aUnderlying conditions included any of the following: asthma, other chronic lung disease, chronic heart disease (valvular heart disease, coronary artery disease, or heart failure excluding hypertension), liver disease (cirrhosis or liver failure), renal disease (nephrotic syndrome, chronic renal failure), immunocompromising conditions excluding HIV infection (organ transplant, immunosuppressive therapy, immunoglobulin deficiency, malignancy), neurological disease (cerebrovascular accident, spinal cord injury, seizures, neuromuscular conditions), or pregnancy. Comorbidities were considered absent in cases for which the medical records stated that the patient had no underlying medical condition or when there was no direct reference to that condition.
bCurrent history.
cAny history of having worked in the mine.
d lytA PCR positive for Streptococcus pneumoniae on blood specimen.
eHistory of TB treatment within the last 12 months of current admission.
fStarted on TB treatment at current admission; excludes those already on TB treatment at time of admission (n = 108).
gInvasive isolates were defined as a bacterial pathogen isolated from blood or pleural fluid from a specimen taken within 48 hours of hospitalization; organisms viewed as likely contaminants were excluded. Two percent (9 of 373) of patients had a positive blood culture (5 S pneumoniae, 2 Staphylococcus aureus, and 1 Escherischia coli). Two percent (2 of 122) of laboratory-confirmed TB patients had a positive blood culture (1 E coli and 1 S aureus).