Article Sidebar
Article Details
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.
Main Article Content
Tuberculosis in an inflammatory bowel disease cohort from South Africa
Abstract
Background. Potent immunosuppressive therapy is standard
treatment for inflammatory bowel disease (IBD) but carries a risk
of reactivating latent tuberculosis (TB). No data exist on the burden
of TB in South African patients with IBD.
Objective. To evaluate the burden of TB in IBD patients attending
a large tertiary IBD clinic.
Methods. Data pertaining to patients attending the Groote Schuur Hospital IBD clinic were retrospectively analysed. Data were extracted from an existing IBD database, patient notes, the National Health Laboratory Services database and chest X-ray analysis.
Results. Of 614 patients, 72 (11.7%) were diagnosed with TB; 40 (55.6%) developed TB prior to the diagnosis of IBD. On regression analysis, coloured IBD patients were at increased risk for TB development (p=0.004, odds ratio (OR) 3.57, 95% confidence interval (CI) 1.49 - 8.56), as were patients with extensive Crohn’s disease (CD) compared with those with less extensive disease (p=0.001, OR 2.84, 95% CI 1.27 - 6.33). No other risk factors, including the use of immunosuppressive agents, were identified for the development of TB.
Conclusions. Of over 600 patients, 12% had TB either before or after IBD diagnosis. The high rate of previous TB and positive association with ethnicity probably reflect the high burden of TB in a socio-economically disadvantaged community. We recommend that IBD patients should be screened actively and monitored for TB when immunosuppressive medications are used.
