30 YEARS RETROSPECTIVE REVIEW OF TUBERCULOSIS CASES IN A TUBERCULOSIS DISPENSARY IN BURSA/NILUFER, TURKEY (1985-2014)
Main Article Content
Keywords
Tuberculosis, Bursa, mortality, control programmes
Abstract
Abstract
Objective: The aim of this study was to evaluate tuberculosis control programmes of patients who applied to the Bursa Nilufer Tuberculosis Dispensary and by investigating the changes in the variables over 3 decades.
Method: In this retrospective descriptive study, the records of all tuberculosis cases (1662 people) treated in the last 30 years (1985-2014) at the Bursa Nilufer Tuberculosis Dispensary were examined. In the analysis, the chi-square test, the trend chi-square test and Fisher's exact test were used. Results: Males comprised 65.2% of the patients. The ages of the patients ranged from 1 to 87 years, and the mean age was 37.4 (95% CI:36.6-38.2). Among the cases, 86.7% were new and 74.1% were pulmonary tuberculosis. In the last decade, the proportion of women, the education level, the proportion of patients who had received a BCG vaccination and the proportion of active employees among women increased by a statistically significant amount, while the proportion of employees among men decreased. Clinical symptoms, such as weakness, anorexia, weight loss, and cough, decreased to a statistically significant degree. In the last decade, the mortality rate was 3.6%, a statistically significant increase compared with previous decades. Mortality was statistically significant higher among patients who were elderly, male, did not have a BCG scar or had a chronic disease. Conclusion: This study reveals the need for studies that determine the risk factors associated with tuberculosis mortality and examine the effectiveness of tuberculosis control programmes. Direct measures to address mortality risk factors can reduce the number of deaths from tuberculosis.
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References
References:
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13. T.C. Sa?l?k Bakanl??? Verem Sava?? Daire Ba?kanl???. 16.09.2003 tarih ve 7546 say?l? yaz?s?.
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15. Orman A, Ünlü M, Cirit M. Afyon Verem Sava? Dispanseri’nde 1990-2000 y?llar? aras?nda izlenen 627 tüberküloz olgusunun de?erlendirilmesi. Solunum Hastal?klar?. 2002; 13: 271-276.
16. Martinez AN, Rhee JT, Small PM, Behr MA. Sex differences in the epidemiology of tuberculosis in San Francisco. The International Journal of Tuberculosis and Lung Disease. 2000; 4(1): 26-31.
17. Çiftçi F, Bozkanat E, ?lvan A, Kartalo?lu Z, Sezer O, Çal??kan T, Kaya H. Referans özelli?i olan bir askeri hastanede tüberkülozlu asker hastalar?n 2003 y?l? tedavi sonuçlar?. Toraks Dergisi. 2006; 7(1): 45-50.
18. T.C. Sa?l?k Bakanl??? Türkiye Halk Sa?l??? Kurumu Tüberküloz Daire Ba?kanl???. Türkiye'de Verem sava?? 2013 Raporu. In: Özkan S, Musaonba??o?lu S, eds. Ankara, Uzman Matbaac?l?k, 2014.
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20. Borgdorff MW, Nagelkerke NJD, Dye C, Nunn P. Gender and tuberculosis: a comparison of prevalence surveys with notification data to explore sex differences in case detection. The International Journal of Tuberculosis and Lung Disease. 2000; 4(2): 123 -132.
21. Neyrolles O, Murci LO. Sexual Inequality in Tuberculosis. PLoS Medicine 2009; 6(12): 1-6.
22. Hudelson P. Gender differentials in tuberculosis: the role of socio-economic and cultural factors. Tubercle and Lung Disease. 1996; 77: 391-400.
23. Tatar D, Keskin Ö, Özacar R, Halilçolar H. Genç ve ya?l? hastalarda tüberkülozun benzer ve farkl? yönleri. Tüberküloz ve Toraks Dergisi. 2002; 50: 485-91.
24. Öztop A, Ünsal ?, Günay T, Özgü A, Çakmak R, Uçku R. Kahramanlar Verem Sava? Dispanseri’nde 1999-2003 y?llar? aras?nda kay?tl? tüberküloz olgular?n?n epidemiyolojik Özellikleri. Solunum Hastal?klar?. 2006; 17: 123-132.
25. K?l?çaslan Z. Tüberküloz Epidemiyolojisi Ve Dünyada Tüberküloz. In: Bilgic H, Karada? M, eds. Toraks Kitaplar? Tüberküloz. ?stanbul, AVES Yay?nc?l?k. 2010; 25-35
26. K?ter G, Co?kunol ?, Alptekin S. ?zmir E?refpa?a Verem Sava? Dispanseri'nde Ocak 1997-Haziran 1998 Döneminde Kay?tl? Tüberkülozlu Hastalar?n De?erlendirilmesi. Tüberküloz ve Toraks Dergisi. 2000; 48(4): 333-339.
27. ?en V, Uluca Ü, Y?lmaz S, Selimo?lu ?en H, Tuncel T, Güne? A, Karabel M, Gürkan MF. Akci?er tüberkülozlu çocuk hastalar?n klinik ve laboratuvar özelliklerinin de?erlendirilmesi. Dicle Medical Journal. 2014; 41(3): 552-557. http://dx.doi.org/10.5798/diclemedj.0921.2014.03.0473 .
28. Young BN, Rendon A, Rosas A, Baker J, Healy M , Gross JM , Long J , Burgos M , Hunley KL. The Effects of Socioeconomic Status, Clinical Factors, and Genetic Ancestry on Pulmonary Tuberculosis Disease in Northeastern Mexico. PLOS ONE 2014; 9(4): 1-8. Epub 2014 April 11, http://dx.doi.org/10.1371/journal.pone.0094303
29. Özbay B, Sezgi C, Alt?nöz O, Serto?ullar?ndan B, Tokgöz N. ?limizde 1999-2003 y?llar? aras?nda saptanan tüberküloz olgular?n?n de?erlendirilmesi. Tüberküloz ve Toraks Dergisi. 2008; 56(4): 396-404.
30. Zengin E, Ki?io?lu AN, Sönmez Y. Isparta Merkez ?lçe Verem Sava?? Dispanseri'nde Kay?tl? Tüberküloz Vakalar?n?n Özellikleri ve Dispanser Kay?tlar?n?n Yeterlilik Durumu: 2000-2007 Y?llar?. SDÜ T?p Fakültesi Dergisi. 2009; 16(3): 14-18
31. Gomes NMDF, Bastos MCDM, Marins RM, et al. Differences between Risk Factors Associated with Tuberculosis Treatment Abandonment and Mortality Pulmonary Medicine, vol. 2015, Article ID 546106, 8 pages, 2015. http://dx.doi.org/10.1155/2015/546106 .
32. Öztürk R. Tüberkülozda Do?al Direnç ve Risk Faktörleri, in 21. Yüzy?lda Tüberküloz Sempozyumu ve II. Tüberküloz Laboratuvar Tan? Yöntemleri Kursu . Samsun: 2003. [online] Available from: http://www.klimik.org.tr/wp-content/uploads/2012/02/982011124221-Recep_Ozturk.pdf. (Accessed: 13/01/2016)
33. AKSEL N, MERTO?LU A, DO?AN H. Akci?er Tüberkülozlu Kad?n ve Erkek Olgular?n Kar??la?t?r?lmas?. ?zmir ?ö?üs Hastanesi Dergisi. 2008. 22(2).
34. Tatar D, Alptekin S, Co?kunol ?, Ayd?n M, Arslangiray S. ?zmir E?refpa?a Verem Sava? Dispanseri’nde 1995-2000 y?llar? aras?nda izlenen çocukluk ça?? tüberküloz olgular?n?n retrospektif analizi. Solunum Hastal?klar? Dergisi. 2002; 13: 94-100.
35. Özkara ?, K?l?çaslan Z, Öztürk F, Seymeno?lu S , Erdo?an AR ,Tellio?lu C ,Ko?an AA, Kaya B, ,Koço?lu F ,Kibaro?lu E. Bölge Verileriyle Türkiye’de Tüberküloz. Toraks Dergisi. 2002; (3) 2: 178-87.
36. Forssbohm M, Zwahlen M, Loddenkemper R, Rieder HL . Demographic characteristics of patients with extrapulmonary tuberculosis in Germany. 2008 Jan;31(1):99-105. Epub 2007 Sep 5. DOI: 10.1183/09031936.00020607
37. Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993–2006. Clin Infect Dis. 2009; 49 (9): 1350-1357. doi: 10.1086/605559
38. Kolsuz M, Ersoy S, Demircan N, Metinta? M, Erginel S, Alata? F, Uçgun ?. Eski?ehir-Deliklita? Verem Sava? Dispanseri’nde izlenen akci?er d??? tüberküloz olgular?n?n de?erlendirilmesi. Toraks Dergisi. 2003; 4(1): 25-32.
39. Miller LG, Asch SM, Emily IY, Knowles L, Gelberg L, Davidson P. A Population-Based Survey of Tuberculosis Symptoms: How Atypical Are Atypical Presentations?. Clin Infect Dis. 2000;30 (2): 293-299. doi: 10.1086/313651.
40. Kayhan S. Demographic and clinical characteristics of tuberculosis: A report of 2404 cases at a referral hospital. African Journal of Microbiology Research 2012; 6(9): 2033-2037.
41. Coldwitz GA, Berkey CS, Mosteller F, Brewer TF, Wilson ME, Burdick E, Fineberg HV. The efficacy of bacillus Calmette-Guerin vaccination of newborns and infants in the prevention of tuberculosis: meta-analyses of the published literature. PEDIATRICS (ISSN 0031 4005). Copyright © 1995 by the American Academy of Pediatrics. 1995; 96 (1):29-35. Available from: http://pediatrics.aappublications.org/content/pediatrics/96/1/29.full.pdf
Accessed:14/02/2016.
42. World Health Organization Geneva. WHO BCG Vaccine [online]. Weekly epidemiological record, 2004; 79: 25-40. Available from: http://www.who.int/wer/2007/wer8221.pdf. Accessed: 14/02/2016.
43. K?l?çaslan Z, Koço?lu F. Türkiye’de Verem Sava??nda Derneklerin Rolü . In: Bilgic H, Karada? M, eds. Toraks Kitaplar? Tüberküloz. ?stanbul, AVES Yay?nc?l?k. 2010; 673-679
44. Beldarrain E. Impact of the 1970 reforms to Cuba's National Tuberculosis Control Program. MEDICC Review. 2015;17(3): 33-38.
45. World Health Organization. Stop TB Partnership and World Health Organization. The Global Plan to Stop TB, 2006-2015: actions for life towards a world free of tuberculosis. WHO, Geneva, Switzerland. 2006; 30. Available from: http://www.stoptb.org/assets/documents/global/plan/globalplanfinal.pdf
46. Jordan TS, Davies PD. Clinical tuberculosis and treatment outcomes. Int J Tuberc Lung Dis 2010; 14(6): 683-8.
1. Ad?güzel H, Durusoy R. Yeni Ortaya Ç?kan ve Yeniden Ortaya Ç?kan Bula??c? Hastal?klar. In: Ertem M, Çan G, eds. Türkiye Sa?l?k Raporu 2014. Edirne, Trakya Üniversitesi Matbaas?. 2014; 102-8.
2. World Health Organization. WHO tuberculosis. Available from: http://www.who.int/mediacentre/factsheets/fs104/en/ (Accesed 02/11/2015)
3. World Health Organization. Global Tuberculosis Report 2015. Available from: http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf?ua=1. (Accessed 02/11/2015)
4. Elbek O. Tüberküloz Kontrolünde Etik Sorunlar. Turk Toraks Derg. 2014; DOI: 10.5152/ttd.2014.4134. Epub 2014 July 11.
5. World Medical Association. Physicians Advised to Treat Tuberculosis as a Disease of Poverty. Available from: http://www.wma.net/en/40news/20archives/2015/2015_43/index.html. (Accesed 25/12/2015)
6. Vidinel ?. Türkiye’de Tüberküloz Hastal???na Tarihsel Bir Bak??. In: Bilgic H, Karada? M, eds. Toraks Kitaplar? Tüberküloz. ?stanbul, AVES Yay?nc?l?k. 2010; 17-24.
7. World Health Organization. WHO tuberculosis . Available from:
9. Özkara ?. Türkiye’de Tüberküloz Epidemiyolojisi. In: Bilgic H, Karada? M, eds. Toraks Kitaplar? Tüberküloz. ?stanbul, AVES Yay?nc?l?k. 2010; 36-47.
10. T.C. Sa?l?k Bakanl???. Tüberküloz Tan? ve Tedavi Rehberi. In: Akda? R, eds. Ankara, Ba?ak Matbaac?l?k ve Tan?t?m Hizmetleri Ltd. ?ti. 2011; 1.
11. Özdemir T, Türkkan? MH, Y?lmaz Ayd?n L , Balc? Ç, Danac?ba? R, Bilgin A. Tüberküloz kontrol program? kapsam?nda il de?erlendirmesi. Tuberk Toraks. 2014; 62(3): 183-190. DOI: 10.5578/tt.7899. Epub 2014 August 7.
12. T.C. Resmi Gazete. Available from: http://www.resmigazete.gov.tr/main.aspx?home=http://www.resmigazete.gov.tr/arsiv/7110.pdf&main=http://www.resmigazete.gov.tr/arsiv/7110.pdf . (Accessed : 01/04/2016)
13. T.C. Sa?l?k Bakanl??? Verem Sava?? Daire Ba?kanl???. 16.09.2003 tarih ve 7546 say?l? yaz?s?.
14. Koçako?lu ?, ?im?ek Z, Ceylan E. 2001-2006 Y?llar? Aras?nda ?anl?urfa Merkez Verem Sava? Dispanserinde Takip Edilen Tüberküloz Olgular?n?n Epidemiyolojik Özellikleri. Tur Toraks Der. 2009;10: 9-14
15. Orman A, Ünlü M, Cirit M. Afyon Verem Sava? Dispanseri’nde 1990-2000 y?llar? aras?nda izlenen 627 tüberküloz olgusunun de?erlendirilmesi. Solunum Hastal?klar?. 2002; 13: 271-276.
16. Martinez AN, Rhee JT, Small PM, Behr MA. Sex differences in the epidemiology of tuberculosis in San Francisco. The International Journal of Tuberculosis and Lung Disease. 2000; 4(1): 26-31.
17. Çiftçi F, Bozkanat E, ?lvan A, Kartalo?lu Z, Sezer O, Çal??kan T, Kaya H. Referans özelli?i olan bir askeri hastanede tüberkülozlu asker hastalar?n 2003 y?l? tedavi sonuçlar?. Toraks Dergisi. 2006; 7(1): 45-50.
18. T.C. Sa?l?k Bakanl??? Türkiye Halk Sa?l??? Kurumu Tüberküloz Daire Ba?kanl???. Türkiye'de Verem sava?? 2013 Raporu. In: Özkan S, Musaonba??o?lu S, eds. Ankara, Uzman Matbaac?l?k, 2014.
19. CDC. Reported Tuberculosis in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services, CDC, October 2015. [online]. Available from: http://www.cdc.gov/tb/statistics/reports/2014/pdfs/tb-surveillance-2014-report.pdf . (Accessed 10/12/2015)
20. Borgdorff MW, Nagelkerke NJD, Dye C, Nunn P. Gender and tuberculosis: a comparison of prevalence surveys with notification data to explore sex differences in case detection. The International Journal of Tuberculosis and Lung Disease. 2000; 4(2): 123 -132.
21. Neyrolles O, Murci LO. Sexual Inequality in Tuberculosis. PLoS Medicine 2009; 6(12): 1-6.
22. Hudelson P. Gender differentials in tuberculosis: the role of socio-economic and cultural factors. Tubercle and Lung Disease. 1996; 77: 391-400.
23. Tatar D, Keskin Ö, Özacar R, Halilçolar H. Genç ve ya?l? hastalarda tüberkülozun benzer ve farkl? yönleri. Tüberküloz ve Toraks Dergisi. 2002; 50: 485-91.
24. Öztop A, Ünsal ?, Günay T, Özgü A, Çakmak R, Uçku R. Kahramanlar Verem Sava? Dispanseri’nde 1999-2003 y?llar? aras?nda kay?tl? tüberküloz olgular?n?n epidemiyolojik Özellikleri. Solunum Hastal?klar?. 2006; 17: 123-132.
25. K?l?çaslan Z. Tüberküloz Epidemiyolojisi Ve Dünyada Tüberküloz. In: Bilgic H, Karada? M, eds. Toraks Kitaplar? Tüberküloz. ?stanbul, AVES Yay?nc?l?k. 2010; 25-35
26. K?ter G, Co?kunol ?, Alptekin S. ?zmir E?refpa?a Verem Sava? Dispanseri'nde Ocak 1997-Haziran 1998 Döneminde Kay?tl? Tüberkülozlu Hastalar?n De?erlendirilmesi. Tüberküloz ve Toraks Dergisi. 2000; 48(4): 333-339.
27. ?en V, Uluca Ü, Y?lmaz S, Selimo?lu ?en H, Tuncel T, Güne? A, Karabel M, Gürkan MF. Akci?er tüberkülozlu çocuk hastalar?n klinik ve laboratuvar özelliklerinin de?erlendirilmesi. Dicle Medical Journal. 2014; 41(3): 552-557. http://dx.doi.org/10.5798/diclemedj.0921.2014.03.0473 .
28. Young BN, Rendon A, Rosas A, Baker J, Healy M , Gross JM , Long J , Burgos M , Hunley KL. The Effects of Socioeconomic Status, Clinical Factors, and Genetic Ancestry on Pulmonary Tuberculosis Disease in Northeastern Mexico. PLOS ONE 2014; 9(4): 1-8. Epub 2014 April 11, http://dx.doi.org/10.1371/journal.pone.0094303
29. Özbay B, Sezgi C, Alt?nöz O, Serto?ullar?ndan B, Tokgöz N. ?limizde 1999-2003 y?llar? aras?nda saptanan tüberküloz olgular?n?n de?erlendirilmesi. Tüberküloz ve Toraks Dergisi. 2008; 56(4): 396-404.
30. Zengin E, Ki?io?lu AN, Sönmez Y. Isparta Merkez ?lçe Verem Sava?? Dispanseri'nde Kay?tl? Tüberküloz Vakalar?n?n Özellikleri ve Dispanser Kay?tlar?n?n Yeterlilik Durumu: 2000-2007 Y?llar?. SDÜ T?p Fakültesi Dergisi. 2009; 16(3): 14-18
31. Gomes NMDF, Bastos MCDM, Marins RM, et al. Differences between Risk Factors Associated with Tuberculosis Treatment Abandonment and Mortality Pulmonary Medicine, vol. 2015, Article ID 546106, 8 pages, 2015. http://dx.doi.org/10.1155/2015/546106 .
32. Öztürk R. Tüberkülozda Do?al Direnç ve Risk Faktörleri, in 21. Yüzy?lda Tüberküloz Sempozyumu ve II. Tüberküloz Laboratuvar Tan? Yöntemleri Kursu . Samsun: 2003. [online] Available from: http://www.klimik.org.tr/wp-content/uploads/2012/02/982011124221-Recep_Ozturk.pdf. (Accessed: 13/01/2016)
33. AKSEL N, MERTO?LU A, DO?AN H. Akci?er Tüberkülozlu Kad?n ve Erkek Olgular?n Kar??la?t?r?lmas?. ?zmir ?ö?üs Hastanesi Dergisi. 2008. 22(2).
34. Tatar D, Alptekin S, Co?kunol ?, Ayd?n M, Arslangiray S. ?zmir E?refpa?a Verem Sava? Dispanseri’nde 1995-2000 y?llar? aras?nda izlenen çocukluk ça?? tüberküloz olgular?n?n retrospektif analizi. Solunum Hastal?klar? Dergisi. 2002; 13: 94-100.
35. Özkara ?, K?l?çaslan Z, Öztürk F, Seymeno?lu S , Erdo?an AR ,Tellio?lu C ,Ko?an AA, Kaya B, ,Koço?lu F ,Kibaro?lu E. Bölge Verileriyle Türkiye’de Tüberküloz. Toraks Dergisi. 2002; (3) 2: 178-87.
36. Forssbohm M, Zwahlen M, Loddenkemper R, Rieder HL . Demographic characteristics of patients with extrapulmonary tuberculosis in Germany. 2008 Jan;31(1):99-105. Epub 2007 Sep 5. DOI: 10.1183/09031936.00020607
37. Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993–2006. Clin Infect Dis. 2009; 49 (9): 1350-1357. doi: 10.1086/605559
38. Kolsuz M, Ersoy S, Demircan N, Metinta? M, Erginel S, Alata? F, Uçgun ?. Eski?ehir-Deliklita? Verem Sava? Dispanseri’nde izlenen akci?er d??? tüberküloz olgular?n?n de?erlendirilmesi. Toraks Dergisi. 2003; 4(1): 25-32.
39. Miller LG, Asch SM, Emily IY, Knowles L, Gelberg L, Davidson P. A Population-Based Survey of Tuberculosis Symptoms: How Atypical Are Atypical Presentations?. Clin Infect Dis. 2000;30 (2): 293-299. doi: 10.1086/313651.
40. Kayhan S. Demographic and clinical characteristics of tuberculosis: A report of 2404 cases at a referral hospital. African Journal of Microbiology Research 2012; 6(9): 2033-2037.
41. Coldwitz GA, Berkey CS, Mosteller F, Brewer TF, Wilson ME, Burdick E, Fineberg HV. The efficacy of bacillus Calmette-Guerin vaccination of newborns and infants in the prevention of tuberculosis: meta-analyses of the published literature. PEDIATRICS (ISSN 0031 4005). Copyright © 1995 by the American Academy of Pediatrics. 1995; 96 (1):29-35. Available from: http://pediatrics.aappublications.org/content/pediatrics/96/1/29.full.pdf
Accessed:14/02/2016.
42. World Health Organization Geneva. WHO BCG Vaccine [online]. Weekly epidemiological record, 2004; 79: 25-40. Available from: http://www.who.int/wer/2007/wer8221.pdf. Accessed: 14/02/2016.
43. K?l?çaslan Z, Koço?lu F. Türkiye’de Verem Sava??nda Derneklerin Rolü . In: Bilgic H, Karada? M, eds. Toraks Kitaplar? Tüberküloz. ?stanbul, AVES Yay?nc?l?k. 2010; 673-679
44. Beldarrain E. Impact of the 1970 reforms to Cuba's National Tuberculosis Control Program. MEDICC Review. 2015;17(3): 33-38.
45. World Health Organization. Stop TB Partnership and World Health Organization. The Global Plan to Stop TB, 2006-2015: actions for life towards a world free of tuberculosis. WHO, Geneva, Switzerland. 2006; 30. Available from: http://www.stoptb.org/assets/documents/global/plan/globalplanfinal.pdf
46. Jordan TS, Davies PD. Clinical tuberculosis and treatment outcomes. Int J Tuberc Lung Dis 2010; 14(6): 683-8.