title: Clinical and epidemiological features of extrapulmonary tuberculosis in a high incidence region.
abstract: OBJECTIVE
  To describe the clinical features of extrapulmonary tuberculosis (EXPTB) and to evaluate epidemiological data to search for potential explanations for its high frequency in the state of Aguascalientes, Mexico.
  
  
  METHODS
  Clinical records of all patients with tuberculosis seen in Aguascalientes in 2008 were reviewed, and official databases were analyzed.
  
  
  RESULTS
  EXPTB comprised 60.5% of the 86 cases evaluated, being lymph nodes the main site affected. Patients with EXPTB were younger and more obese than subjects with pulmonary tuberculosis (PTB). One third of cases in either group had diabetes, a frequency much higher than expected. Epidemiological analysis showed that PTB incidence, but not EXPTB incidence, decreases as geographical altitude increases, and had a descendent trend from 1997 to 2011.
  
  
  CONCLUSIONS
  The lower frequency of PTB (due to its inverse relationship with altitude and its descendent trend in last years) might explain the high frequency of EXPTB. Obesity appeared to protect against developing pulmonary involvement, and diabetes was more frequent than expected among PTB and EXPTB cases.
authors.affiliation: Secretaría de Salud del Estado de Aguascalientes, Aguascalientes, México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Pérez-Guzmán
authors.affiliation: Instituto Nacional de Enfermedades Respiratorias, México, DF, México.
authors.forename: Mario H
authors.initials: MH
authors.lastname: Vargas
authors.affiliation: Secretaría de Salud del Estado de Aguascalientes, Aguascalientes, México.
authors.forename: María del Rosario
authors.initials: Mdel R
authors.lastname: Arellano-Macías
authors.affiliation: Secretaría de Salud del Estado de Aguascalientes, Aguascalientes, México.
authors.forename: Silvia
authors.initials: S
authors.lastname: Hernández-Cobos
authors.affiliation: Secretaría de Salud del Estado de Aguascalientes, Aguascalientes, México.
authors.forename: Aurea Zelindabeth
authors.initials: AZ
authors.lastname: García-Ituarte
authors.affiliation: Secretaría de Salud del Estado de Aguascalientes, Aguascalientes, México.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Serna-Vela
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology*