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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2020  |  Volume : 31  |  Issue : 3  |  Page : 701-702
Expected tuberculosis detection rate among the patients with chronic kidney disease: A report from endemic country of tuberculosis


1 Private Academic Practice, Bangkok, Thailand
2 Department of Community Medicine, Dr. D. Y. Patil University, Pune, Maharashtra, India

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Date of Submission20-Jul-2019
Date of Acceptance22-Jul-2019
Date of Web Publication10-Jul-2020
 

How to cite this article:
Sookaromdee P, Wiwanitkit V. Expected tuberculosis detection rate among the patients with chronic kidney disease: A report from endemic country of tuberculosis. Saudi J Kidney Dis Transpl 2020;31:701-2

How to cite this URL:
Sookaromdee P, Wiwanitkit V. Expected tuberculosis detection rate among the patients with chronic kidney disease: A report from endemic country of tuberculosis. Saudi J Kidney Dis Transpl [serial online] 2020 [cited 2020 Aug 4];31:701-2. Available from: http://www.sjkdt.org/text.asp?2020/31/3/701/289461


To the Editor,

Tuberculosis (TB) is an important infectious disease that is a present public problem worldwide. Several groups of patients are at risk for getting the infection. The patient with chronic kidney disease is an important group of patients with immune defects that might have an increased chance to get TB infection. In an area where TB is highly endemic, the patient with chronic kidney disease (CKD) becomes an important group for TB control and prevention.[1] According to a recent metaanalysis by Al-Efraij et al, there was an increased risk of TB among the patients with end-stage kidney disease.[2]

In Thailand, a tropical country in Indochina, TB is endemic and known as a problematic country with problem in TB control.[3],[4],[5] To manipulate the problem, the active TB case searching has just been used in Thailand. Here, the authors reappraise on the public available epidemiology data on active TB case searching in a rural province in Thailand, namely Suphanburi (available online at bie.moph.go. th/e-insreport/file_province/5-66-1-2019-02- 22-09-27-51.pdf). The setting is 220 km to the north direction of Bangkok, capital of Thailand. Based on the screening policies, the active screening consists of chest radiography and sputum microbiological examination is applied for all patients with CKD.

The local record regarding active TB case searching among the patients with CKD by screening in the studied province during the year 2018 was retrospectively analyzed. Based on the available data, there are 5281 focused patients in this province, and the complete active screening was successfully done in 4,378 patients (83.2%). For the screening result, there are 11 identified TB cases (0.25% of overall screened cases, which is equal to 250/100,000 population), giving the expected range, 95% confidence interval, between 0.14% and 0.45%. The observed TB rate among the patients with CKD is higher than that of general Thai people, which is 156 per 100,000 population according to the official report by the Thai Ministry of Public Health (https://www.tbthailand.org/). A high expected chance to get TB in the patient with chronic kidney could be identified in our settings, implying the use of implementation of an active TB searching program for the patients with CKD in our setting. This is concordant with the observation that there is a higher incidence of TB from screening in patients with CKD to the general population in China.[6] A similar advantage is expected in other settings with a similar high burden of TB.

Conflict of interest: None declared.



 
   References Top

1.
Romanowski K, Clark EG, Levin A, Cook VJ, Johnston JC. Tuberculosis and chronic kidney disease: An emerging global syndemic. Kidney Int 2016;90:34-40.  Back to cited text no. 1
    
2.
Al-Efraij K, Mota L, Lunny C, Schachter M, Cook V, Johnston J. Risk of active tuberculosis in chronic kidney disease: A systematic review and meta-analysis. Int J Tuberc Lung Dis 2015;19:1493-9.  Back to cited text no. 2
    
3.
Paton NI, Borand L, Benedicto J, et al. Diagnosis and management of latent tuberculosis infection in Asia: Review of current status and challenges. Int J Infect Dis 2019; 87:21-9.  Back to cited text no. 3
    
4.
Wise J. WHO identifies 16 countries struggling to control tuberculosis. BMJ 1998;316:957.  Back to cited text no. 4
    
5.
Khan MK, Islam MN, Ferdous J, Alam MM. An Overview on Epidemiology of Tuberculosis. Mymensingh Med J 2019;28:259-66.  Back to cited text no. 5
    
6.
Shen TC, Huang KY, Chao CH, et al. The risk of chronic kidney disease in tuberculosis: A population-based cohort study. QJM 2015;108: 397-403.  Back to cited text no. 6
    

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Correspondence Address:
Pathum Sookaromdee
Private Academic Practice, Bangkok
Thailand
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DOI: 10.4103/1319-2442.289461

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