Musculoskeletal tuberculosis in Bradford

Author:

Craig Andrew D.1ORCID,Asmar Samir1,Whitaker Paul2ORCID,Shaw David L.1,Saralaya Dinesh3

Affiliation:

1. Department of Trauma & Orthopaedics, Bradford Royal Infirmary, Bradford, UK

2. Department of Infectious Diseases, Bradford Royal Infirmary, Bradford, UK

3. Department of Respiratory Medicine, Bradford Royal Infirmary, Bradford, UK

Abstract

AimsTuberculosis (TB) is one of the biggest communicable causes of mortality worldwide. While incidence in the UK has continued to fall since 2011, Bradford retains one of the highest TB rates in the UK. This study aims to examine the local disease burden of musculoskeletal (MSK) TB, by analyzing common presenting factors within the famously diverse population of Bradford.MethodsAn observational study was conducted, using data from the Bradford Teaching Hospitals TB database of patients with a formal diagnosis of MSK TB between January 2005 and July 2017. Patient data included demographic data (including nationality/date of entry to the UK), disease focus, microbiology, and management strategies. Disease incidence was calculated using population data from the Office for National Statistics. Poisson confidence intervals were calculated to demonstrate the extent of statistical error. Disease incidence and nationality were also analyzed, and correlation sought, using the chi-squared test.ResultsBetween January 2005 and July 2017, 109 cases of MSK TB were diagnosed in Bradford. Mean incidence was 1.65 per 100,000 population, per calendar year (SD 0.75). A total of 38 cases required surgical intervention. Low rates of antimicrobial resistance were encountered. A low rate of loss to follow-up was observed (four patients; 3.7%). Overall, 94.5% of patients (n = 103) were successfully treated. 67% of patients (n = 73) reported their country of origin as either India, Pakistan, or Bangladesh. These ethnicities account for around 25% of the local population.ConclusionBradford maintains a high prevalence of MSK TB infection relative to national data; the prevalence within the local immigrant population remains grossly disproportionate. Typical associated factors (HIV/hepatitis coinfection, drug resistance), have only modest prevalence in our dataset. However, local socioeconomic factors such as deprivation and poverty appear germane as suggested by global literature. We advocate a high degree of suspicion in treatment of atypical infection in any area with similar population factors to ensure timely diagnosis. Cite this article: Bone Jt Open 2022;3(5):432–440.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Surgery,Orthopedics and Sports Medicine

Reference32 articles.

1. Bradford at Work: People and Industries Through the Years. Northern Life. https://northernlifemagazine.co.uk/bradford-at-work-people-and-industries-through-the-years

2. Ramamurthy A. Resisting racism: the Bradford 12 defence campaign. Our Migration Story. https://www.ourmigrationstory.org.uk/oms/resisting-racism-the-bradford-12-defence-campaign (date last accessed 6 May 2022).

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