The association between skeletal lesions and tuberculosis in a South African sample
Date
2021
Authors
Masiu, Rethabile
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Abstract
Tuberculosis is an infectious disease. Skeletal TB is the extra-pulmonary manifestation of Mycobacterium tuberculosis infection and occurs in about 1-5% of
all TB cases. The aim of this study was to assess the sensitivity and specificity of skeletal lesions to accurately diagnose TB in a pre-antibiotic South African skeletal sample. For this purpose, 23 skeletal lesions were assessed on 436 skeletons from the Raymond A. Dart Skeletal Collection. These skeletons were divided into three groups: individuals where TB was recorded as cause of death (n=177), individuals where other pulmonary diseases were recorded as cause of death (n=109) and individuals where a variety of diseases, excluding TB and other pulmonary diseases, were recorded as causes of death (n=150). Chi-squared and Fisher’s Exact tests were used to assess differences between groups. The skeletal lesions’ respective sensitivities and specificities were also calculated and compared to a similar study by Dangvard Pedersen et al. (2019a). Lesions on the ventral surface of thoracic and lumbar vertebral bodies were observed significantly more in TB cases than in controls. This lesion type was also found to be the most valuable indicator with a high sensitivity and 55% probability of a true TB diagnosis if observed. An association between skeletal lesions and TB could only be found for rib and vertebral lesions. Distinct differences between this study and the study by Dangvard Pedersen et al. (2019a) indicated that TB-related changes were likely to be observed in a South African skeletal sample even when individuals were not documented to have died of the disease.
Description
A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand in fulfilment of the requirements for the degree of Master of
Science, 2021