Epidemiology

According to the World Health Organization (WHO), every year an estimated 10 million people develop TB, and there are an estimated 1.5 million TB-related deaths.[4] In 2020, disruption caused by the coronavirus disease 2019 (COVID-19) pandemic resulted in a large global decrease in the number of reported new cases; however, the number of reported cases has increased again, with WHO estimating that in 2022 there were 1.3 million TB-related deaths, including 167,000 TB-related deaths among people with HIV.[5]​ The increase in TB-related deaths between 2019 and 2021 reverses years of decline between 2005 and 2019.

Of the 8331 reported cases of active TB in the US in 2021, 18.8% had EPTB only and 10.6% had both pulmonary and extrapulmonary sites of TB.[6]​ In the 2022 US surveillance report, EPTB included lymphatic (26.1% of EPTB), pleural (22.1%), bone or joint (9.4%), peritoneal (6.3%), meningeal (5.8%), genitourinary (4.2%), laryngeal (1.1%), and "other" (25.1%).[6]​ Patients born outside the US accounted for 73.8% of the total cases of TB in 2022.[6]​ The TB incidence rate was 0.8 in 100,000 for US-born people, and 13 for non-US-born people.[6]​​

Risk factors for EPTB in the US, in addition to HIV infection, include black ethnicity, female sex, young age, and having cirrhosis.[7][8]

In 2022, 170,365 cases of TB were reported in the WHO European Region and 17.0% of these had EPTB.[9]​​ In England, there were 4425 TB cases in 2021, and 47.3% of these had EPTB.[10]​​

TB is particularly devastating in areas with a high prevalence of HIV-infection, such as sub-Saharan Africa.[11] The Global Burden of Disease Study reports that in 2019, there were 217,000 (153,000-279,000) deaths due to tuberculosis among people with HIV and 1.15 million (1.01 to 1.32) incident cases.[12]

TB lymphadenitis was historically considered a disease of childhood, but it is now commonly seen in the young to middle-aged adult population. An increased prevalence has been noted in Asian and black women from TB-endemic areas.

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