<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1652-6776</journal-id>
<journal-title><![CDATA[Cuadernos Hospital de Clínicas]]></journal-title>
<abbrev-journal-title><![CDATA[Cuad. - Hosp. Clín.]]></abbrev-journal-title>
<issn>1652-6776</issn>
<publisher>
<publisher-name><![CDATA[Universidad Mayor de San Andrés, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1652-67762025000100031</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[ANÁLISIS EPIDEMIOLÓGICO DE LA TUBERCULOSIS EXTRAPULMONAR DIAGNOSTICADA POR qPCR EN EL INSTITUTO SELADIS: IMPACTO DE LA PANDEMIA COVID-19]]></article-title>
<article-title xml:lang="en"><![CDATA[EPIDEMIOLOGICAL ANALYSIS OF EXTRAPULMONARY TUBERCULOSIS DIAGNOSED BY QPCR AT THE SELADIS INSTITUTE: IMPACT OF THE COVID-19 PANDEMIC]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Callapa Rafael]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Conde Chipana]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cerruto Núñez]]></surname>
<given-names><![CDATA[Y.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Revollo Zepita]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,aff1  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2025</year>
</pub-date>
<volume>66</volume>
<numero>1</numero>
<fpage>31</fpage>
<lpage>43</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_arttext&amp;pid=S1652-67762025000100031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_abstract&amp;pid=S1652-67762025000100031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_pdf&amp;pid=S1652-67762025000100031&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN INTRODUCCIÓN La tuberculosis extrapulmonar (TBEP) es una forma menos común pero clínicamente relevante de la tuberculosis, que afecta órganos fuera del sistema respiratorio. Su diagnóstico presenta desafíos debido a la variabilidad clínica y a la limitada sensibilidad de los métodos tradicionales. Este estudio analiza los casos de TBEP confirmados por qPCR en el Instituto SELADIS entre 2019 y 2023 para identificar posibles variaciones en su incidencia asociadas al contexto de la pandemia de COVID-19. OBJETIVO Evaluar la frecuencia de la TBEP diagnosticada por qPCR período 2019-2023 en el Laboratorio de Genética Molecular del Instituto SELADIS y analizar la posible correlación temporal con la pandemia de COVID-19. MÉTODOS Se realizó un estudio observacional, retrospectivo y transversal, basado en el análisis de registros de laboratorio correspondientes a pacientes con sospecha de tuberculosis extrapulmonar (TBEP) evaluados por qPCR entre 2019 y 2023 en el Laboratorio de Genética Molecular del Instituto SELADIS. Se analizaron un total de 1048 casos sospechosos, calculando la frecuencia de resultados positivos por año. Se utilizaron métodos de estadística descriptiva para examinar las variaciones anuales, y estadística analítica para explorar la posible asociación temporal entre la frecuencia de detección de TBEP y los periodos de alta incidencia de COVID-19. Se analizaron un total de 1.048 registros de pacientes con sospecha de TBEP, calculando la proporción de resultados positivos por año. Se aplicaron métodos de estadística descriptiva para examinar las variaciones anuales en la frecuencia de detección, y estadística analítica para evaluar su posible asociación temporal con los periodos críticos de la pandemia de COVID-19. RESULTADOS En 2020, coincidiendo con el inicio de la pandemia, se observó un aumento en la frecuencia de casos positivos (11,11%), alcanzando un pico máximo en 2021 (15,87%). En 2022, a pesar de un incremento en el número total de casos analizados, la proporción de positivos disminuyó a 2,38%. Para 2023, la proporción de casos positivos se estabilizó en 4,56%, similar a los niveles previos a la pandemia. CONCLUSIONES Los resultados sugieren que la pandemia de COVID-19 tuvo un impacto temporal en la frecuencia de detección de TBEP, posiblemente relacionado con la sobrecarga del sistema de salud y una mayor vulnerabilidad a infecciones durante ese periodo. No obstante, esta influencia parece haberse reducido en los años posteriores, con una proporción de casos positivos que retorna a niveles similares a los observados antes de la pandemia en 2023.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT INTRODUCTION Extrapulmonary tuberculosis (EPTB) is a less common but clinically relevant form of tuberculosis that affects organs outside the respiratory system. Its diagnosis presents challenges due to clinical variability and the limited sensitivity of traditional methods. This study analyzes cases of EPTB confirmed by qPCR at the SELADIS Institute between 2019 and 2023 to identify possible variations in its incidence associated with the context of the COVID-19 pandemic. OBJECTIVE To evaluate the frequency of EPTB diagnosed by qPCR during the 2019-2023 period in the Molecular Genetics Laboratory of the SELADIS Institute and analyze the possible temporal correlation with the COVID-19 pandemic. METHODS An observational, retrospective, cross-sectional study was conducted based on the analysis of laboratory records corresponding to patients with suspected extrapulmonary tuberculosis (EPTB) evaluated by qPCR between 2019 and 2023 at the Molecular Genetics Laboratory of the SELADIS Institute. A total of 1,048 suspected cases were analyzed, calculating the frequency of positive results per year. Descriptive statistical methods were used to examine annual variations, and analytical statistics were used to explore the possible temporal association between the frequency of EPTB detection and periods of high COVID-19 incidence. A total of 1,048 records of patients with suspected EPTB were analyzed, calculating the proportion of positive results per year. Descriptive statistical methods were applied to examine annual variations in the detection frequency, and analytical statistics were used to evaluate its possible temporal association with critical periods of the COVID-19 pandemic. RESULTS In 2020, coinciding with the onset of the pandemic, an increase in the frequency of positive cases was observed (11.11%), reaching a peak in 2021 (15.87%). In 2022, despite an increase in the total number of cases analyzed, the proportion of positive cases decreased to 2.38%. By 2023, the proportion of positive cases stabilized at 4.56%, similar to pre-pandemic levels. CONCLUSIONS The results suggest that the COVID-19 pandemic had a temporary impact on the frequency of EPTB detection, possibly related to the overload of the health system and greater vulnerability to infections during that period. However, this influence appears to have diminished in subsequent years, with the proportion of positive cases returning to levels similar to those observed before the pandemic in 2023.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Tuberculosis Extrapulmonar]]></kwd>
<kwd lng="es"><![CDATA[qPCR]]></kwd>
<kwd lng="es"><![CDATA[Pandemia de COVID-19]]></kwd>
<kwd lng="es"><![CDATA[Epidemiología]]></kwd>
<kwd lng="en"><![CDATA[Extrapulmonary tuberculosis]]></kwd>
<kwd lng="en"><![CDATA[qPCR]]></kwd>
<kwd lng="en"><![CDATA[COVID-19 pandemic]]></kwd>
<kwd lng="en"><![CDATA[Epidemiology]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Herrera]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Herrador]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Día mundial de la tuberculosis -24 de marzo]]></article-title>
<source><![CDATA[Boletín Epidemiológico Semanal]]></source>
<year>2024</year>
<volume>32</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>7-9</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernández-Solis]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis extrapulmonar: un problema de salud pública]]></article-title>
<source><![CDATA[Cir]]></source>
<year>2023</year>
<volume>91</volume>
<numero>1</numero>
<issue>1</issue>
<publisher-loc><![CDATA[Mexico ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramírez-Lapausa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Menéndez-Saldaña]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Noguerado-Asensio]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis extrapulmonar, una revisión]]></article-title>
<source><![CDATA[Revista Española de Sanidad Penitenciaria]]></source>
<year>2015</year>
<volume>17</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>3-11</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="">
<collab>OPS/OMS</collab>
<source><![CDATA[La COVID-19 es ahora un problema de salud establecido y persistente]]></source>
<year>2023</year>
</nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="">
<collab>OPS</collab>
<source><![CDATA[La Covid-19 y la prestación de servicios de salud]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Malik]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Safdar]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Chandir]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Khowaja]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Riaz]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tuberculosis control and care in the era of COVID-19]]></article-title>
<source><![CDATA[Health Policy Plan]]></source>
<year>2020</year>
<page-range>109</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Migliori]]></surname>
<given-names><![CDATA[GB]]></given-names>
</name>
<name>
<surname><![CDATA[Thong]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Alffenaar]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
<name>
<surname><![CDATA[Denholm]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tadolini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Alyaquobi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gauging the impact of the COVID-19 pandemic on tuberculosis services: a global study]]></article-title>
<source><![CDATA[Eur Respir J]]></source>
<year>2021</year>
<volume>58</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>2101786</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="">
<collab>OMS</collab>
<source><![CDATA[Aumenta la morbimortalidad por tuberculosis durante la pandemia de COVID-19]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[GeneProof PathogenFree]]></surname>
<given-names><![CDATA[DNA]]></given-names>
</name>
</person-group>
<source><![CDATA[Isolation Kit]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="">
<collab>GENTAUR</collab>
<source><![CDATA[MTB RT-PCR (CE) | B15-50FRT]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="">
<collab>SAMFyC</collab>
<source><![CDATA[CasosClinicos y Atención Primaria]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="">
<collab>Ministerio de Salud y Deportes de Bolivia</collab>
<source><![CDATA[El gobierno reafirma su compromiso en intensificar la lucha contra la Tuberculosis]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[MaytaAli]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Oseo Cabás]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Contreras]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Tuberculosis Urogenital. Revista de Actualización Clínica Investiga]]></source>
<year></year>
<page-range>544</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="">
<collab>Manual MSD versión para profesionales</collab>
<source><![CDATA[Tuberculosis extrapulmonar - Enfermedades infecciosas]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="">
<collab>CEPAL</collab>
<source><![CDATA[La pandemia por COVID-19 y su relación con las enfermedades no transmisibles y la protección social en salud]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Revollo]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Taborga]]></surname>
<given-names><![CDATA[X.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnóstico de tuberculosis extrapulmonar mediante la reacción en cadena de la polimerasa]]></article-title>
<source><![CDATA[ConCiencia]]></source>
<year>2013</year>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chaves]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Buitrago]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Dueñas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bejarano]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acerca de la tuberculosis extrapulmonar]]></article-title>
<source><![CDATA[Repert Med Cir]]></source>
<year>2017</year>
<volume>26</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>90-7</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="">
<collab>Coinfección TB/VIH</collab>
<source><![CDATA[Guía Clínica Regional. Actualización]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Velásquez Gortaire]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Sívori]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Jajati]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Trullás]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
<name>
<surname><![CDATA[Velásquez Gortaire]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Sívori]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coinfección de COVID-19 y tuberculosis extrapulmonar]]></article-title>
<source><![CDATA[Medicina]]></source>
<year>2022</year>
<volume>82</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>167-71</page-range><publisher-loc><![CDATA[Buenos Aires ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="">
<collab>ONU</collab>
<source><![CDATA[La interrupción de servicios de salud por la pandemia de COVID-19 causó 69.000 muertes por malaria]]></source>
<year>2021</year>
</nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="">
<collab>CDCTB</collab>
<source><![CDATA[Tuberculosis (TB): Recursos sobre la infección de tuberculosis latente]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B22">
<nlm-citation citation-type="">
<collab>OPS</collab>
<source><![CDATA[La relajación de las medidas de salud pública contribuyó al aumento de las muertes por COVID-19 en las Américas]]></source>
<year>2022</year>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
