Pulmonary tuberculosis at Patan Hospital, Nepal: One year audit

Abstract

Background Globally, Tuberculosis (TB) is one of the top 10 causes of death. In Nepal, poverty and malnutrition aggravate the burden of TB. To identify Mycobacterium tuberculosis s putum is the best sample to identify the bacterium which is helpful for diagnosis. The aim of this study is to identify the situation, burden and challenges of pulmonary tuberculosis in low-middle income country like Nepal. Method A retrospective-audit with reliable-secondary-data of one year was collected (n = 4131). Descriptive-analysis was performed using frequency, percentage and analytical using chi-square-test. Level of significance was set at p < 0.05. Ethical Approval was obtained from IRC-PAHS. Result The prevalence of notified/suspected cases was highest among the patients having >60 years of age 1344(32.54%) and least among the patients with ≤15 years of age 239(5.79%). The male had 1.67 times more smear-positive pulmonary TB cases. Among the AFB-positive cases, smear 3+ was seen in most of the cases 69(38.54%) followed by smear 1+ and smear 2+ in 56(31.28%) and 54(30.16%) respectively. Conclusion The prevalence of smear-positive pulmonary TB case is higher in male. Smear 3+ is seen in most of the followed by smear 1+ and smear 2+. The Burden of Pulmonary TB is more among adult and old-age-people and its control is a challenge for developing and low-middle income countries like Nepal.

The diagnostic concordance between micro real-time PCR and Lowenstein Jensen (LJ) media assays for pulmonary tuberculosis detection with associated clinical characteristics

“…22 In Patan Hospital, the oldest patients (32.54%) had the highest rate of tuberculosis, although the youngest patients (5.79%) had the lowest prevalence. 23 In Ethiopia, a higher prevalence of tuberculosis was in the 15-24 age group, followed by 25-34 years. 24 But in Nigeria, the highest prevalence (17%) was in the age group 30-43 years, 25 in Malaysia 21-40 years (37%), and in Pakistan < 20 years (48.08%).…”

“…29 According to a different survey, men were more common than women in certain districts of Nepal, including Ramechhap, Gorkha, Jumla, and Chitwan. 22,23,29 However, in Pakistan, women (57.63%) had a higher infection rate than men (42.37%). 26 It was possible because, Males increased exposure to the environment, frequent travel, social contact, and professions associated with higher tuberculosis risk, such as mining, contribute to increased transmission.…”

GeneXpert and Acid-Fast Bacilli Smear for Diagnosis of Pulmonary Tuberculosis in a Tertiary Care Center of Rural Nepal

“…The disease may transform into the active phase in 10% of cases and the lungs are the most common place of involvement. 4 Pulmonary TB is the most common presenting form and the form with the highest transmission rates. 5 Mycobacterial culture is the well-known standard test for the diagnosis of TB, and it can detect as low as 10 bacilli/ml of the specimen, but it is time-consuming and requires specialized laboratory infrastructure.…”