Incidence and profile of spinal tuberculosis in patients at the only public hospital admitting such patients in KwaZulu-Natal

Study Design: A retrospective chart review at the major provincial public hospital serving patients with spinal injuries/pathology. Objectives and setting: To determine the incidence of spinal tuberculosis (Tb) and establish the profile of these patients treated at King George V Hospital (KGV) in KwaZulu-Natal, South Africa. Methods: A total of 525 medical records for the period March 2005 to April 2006 were reviewed. Data from 104 files of Tb spine cases were categorized according to demographic details, medical conditions and length of stay in hospital. The South African mid-year 2006 census was used to calculate associations and risk rates for race, gender, adulthood, urbanization and employment and analyzed using the STATA version 9.0 statistical package. Results: About 90% of the patients were African and 10% from other races. Females comprised 58% of the patients. The incidence of Tb spine is 1.02 per 100 000 and 3.13 per 100 000 for Africans and other races, respectively. The incidence rate is 1.17 per 100 000 females and 0.916 per 100 000 males. All the participants had a history of pulmonary Tb and 28% were human immunodeficiency virus positive. Thoracic spine was affected in 42% of the cases. About 32% presented with incomplete paraplegia. The average length of stay at this hospital for these patients was 41 days. Conclusions: About 20% of all patients seen for spinal conditions at KGV over the past year presented with Tb spine. A higher association between living in an urban area, adulthood (age 18+), being non-Black patients and the occurrence of spinal Tb was observed.