Background: Tuberculosis (TB) is a worldwide public health problem. India has the highest TB burden in the world. India accounted for a quarter of global incident TB cases, 24% of multi drug resistance (MDR) TB cases and highest TB mortality rate in 2017. Thus it is important to understand the profile of TB patients. The objective of the study was to assess the profile of TB cases attending a directly observed treatment short-course (DOTS) center in North Kerala.Methods: A retrospective record based, descriptive study was done in the DOTS center of Government Medical College Kannur, in North Kerala, to assess the profile of TB patients who attended the centre from January 2015 to July 2018. Details of 548 patients were collected from the record maintained at DOTS center. Data was entered in Microsoft Excel and analysed using Epi info7 software.Results: The age group of 21-60 years was most affected. 68.53% of the patients were males. 45.62% of patients had extra-pulmonary TB (EPTB). Among the pulmonary TB patients, 74.27% tested positive for acid fast bacilli. Among cases of EPTB, most common type was TB lymphadenitis (40.8%) followed by tuberculous pleural effusion (22.4%). 87.59% of TB patients were started on category I treatment under DOTS.Conclusions: In our study, affected population was mostly males and those in productive age group. This is the group that has maximum chances of exposure to TB patients. 45.62% patients had EPTB. Total number of cases is on the rise each year, with maximum cases in 2018.
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Background Nucleic acid amplification (NAA) tests rapidly detect Mycobacterium tuberculosis complex directly from clinical specimens, providing valuable results for those evaluated for tuberculosis. Methods We analyzed characteristics of cases with NAA testing performed, compared cases with positive and negative NAA test results, and calculated turnaround time and time-to-treatment for all verified cases reported to the National Tuberculosis Surveillance System in the United States during 2011–2017. Results Among 67,082 verified tuberculosis cases with NAA testing information, 30,820 (45.9%) were reported as not having a NAA test performed; the proportion without NAA testing declined annually, from 60.5% in 2011 to 33.6% in 2017. Of 67,082 verified cases, 27,912 (41.6%) had positive, 8,215 (12.2%) had negative, and 135 (0.2%) had indeterminate NAA test results. Among the 33,937 cases with an acid-fast-bacilli–smear-positive result, 70.9% (24,093) had a NAA test performed; 38.0% (11,490) of the 30,244 with an acid-fast-bacilli–smear-negative result had a NAA test performed. Although sputum was the most common specimen type tested, 79.8% (7,023 of 8,804) of non-sputum specimen types had a positive NAA test result. Overall, 63.7% of cases with laboratory testing had NAA test results reported <6 days following specimen collection; for 13,891 cases not yet on treatment, median time-to-treatment after the laboratory report date was 2 days. Conclusions Our analyses demonstrate increased NAA test utilization between 2011 and 2017. However, a large proportion of cases did not have a NAA test performed, reflecting challenges in broader uptake, suggesting an opportunity to expand use of this diagnostic methodology.
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