Treatment outcome of extrapulmonary tuberculosis under Revised National Tuberculosis Control Programme

Cherian, Johnson; Lobo, Ivona; Sukhlecha, Anupama; Chawan, U.; Kshirsagar, N.A.; Nair, Bigesh; Sawardekar, L.

doi:10.1016/j.ijtb.2016.11.028

Cited by 42 publications

(25 citation statements)

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“…The treatment success rate for EPTB in our study was comparable to what Gomes et al . reports for EPTB patients in Brazil but lower than what was reported by studies conducted in Benin, Ethiopia and India [10,15, 32,33]. On the other hand, it is higher than what was reported by other researchers in Nigeria [34,35].…”

Section: Discussionmentioning

confidence: 60%

Extra-pulmonary tuberculosis: A retrospective study of patients in Accra, Ghana

et al. 2019

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BackgroundInformation on extrapulmonary TB (EPTB) patients is limited in many African countries including Ghana. The study objective was to describe the epidemiology of EPTB patients diagnosed from different categories of health facilities in Accra, Ghana compared to pulmonary TB (PTB) patients and identify risk factors for mortality among EPTB patients.MethodWe conducted retrospective analyses of demographic and clinical data accessed from medical records of EPTB and PTB patients from different types of health facilities from June 2010 to December 2013. Factors at diagnosis associated with EPTB compared to pulmonary TB (PTB) and factors associated with treatment outcome death among EPTB patients were assessed using logistic regression.ResultsOut of 3,342 new TB patients ≥15 years diagnosed, 728 (21.8%) had EPTB with a male: female ratio of 1.17. The EPTB sites commonly affected were disseminated 32.8%, pleura 21%, spine 13%, and Central Nervous System (CNS) 11%. Treatment success rate for EPTB was 70.1% compared to 84.2% for PTB (p<0.001). In logistic regression, HIV positivity (adjusted Odds Ratio [aOR] 3.19; 95% confidence interval [CI] 2.69–3.79) and female gender (aOR 1.59; 95% CI 1.35–1.88) were found to be significantly associated with EPTB compared with PTB. Older age, being HIV positive (aOR 3.15; 95% CI 1.20–8.25) and having CNS TB (aOR 3.88; 95% CI 1.14–13.23) were associated with mortality among EPTB patients. While more EPTB patients were diagnosed in the tertiary hospital, health facility type was not associated with mortality.ConclusionEPTB patients in Accra have a worse treatment outcome compared to PTB patients with mortality of EPTB being associated with HIV, older age and CNS TB. Being HIV positive and female gender were found to be significantly associated with EPTB. Increased awareness of these factors may facilitate early case finding and better management outcomes for these patients.

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Section: Discussionmentioning

confidence: 60%

Extra-pulmonary tuberculosis: A retrospective study of patients in Accra, Ghana

et al. 2019

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“…Beside children, higher rates of abdominal TB was also reported in adult TB patients from KP and FATA. While surveillance data analysis of EPTB patients from high income countries have reported low prevalence (<5%) of abdominal TB [3,4,8], but prevalence varying from 6.8% (Afghanistan), 12.8% (India), 14.8% (Nepal), 15.4% (Australia) and 17.5% (Saudi Arabia) are reported mostly in hospital-based small studies [28][29][30][31][32]. The drivers of TB in children including the high levels of chronic and acute malnutrition do still exist in Pakistan, with over 10 million stunted children [27].…”

Section: Plos Onementioning

confidence: 99%

Extrapulmonary tuberculosis in Pakistan- A nation-wide multicenter retrospective study

Tahseen

Khanzada²,

Baloch

et al. 2020

PLoS ONE

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Background Pakistan is fifth among high burden countries for tuberculosis. A steady increase is seen in extrapulmonary tuberculosis (EPTB), which now accounts for 20% of all notified TB cases. There is very limited information on the epidemiology of EPTB. This study was performed with the aim to describe the demographic characteristics, clinical manifestations and treatment outcomes of EPTB patients in Pakistan. Method We performed descriptive analysis on routinely collected data for cohorts of TB patients registered nationwide in 2016 at health facilities selected using stratified convenient sampling. Findings Altogether 54092 TB including 15790 (29.2%) EPTB cases were registered in 2016 at 50 study sites. The median age was 24 years for EPTB and 30 years for PTB patients. The crude prevalence of EPTB in females was 30.5% (95%CI; 29.9-31.0) compared to 27.9% (95%CI; 27.3-28.4) in males. The likelihood of having EPTB (OR), was 1.1 times greater for females, 2.0 times for children, and 3.3 times for residents of provinces in the NorthWest .

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“…17,18 In contrast ,a study by Cherian JJ et al, the commonest site of EPTB was lymph node (34.4%). 19 Even though we excluded children from our study but lymph node TB is more common in children than pleura. 18 Though culture is more sensitive than microscopy, in developing countries, diagnosis is primarily based on AFB microscopy owing to its simplicity, less cost and rapidity.…”

Section: Resultsmentioning

confidence: 99%

Tuberculosis: an experience at government chest disease hospital

Farooq¹,

Mehfooz²,

Dar³

et al. 2018

Int J Res Med Sci

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Background: This retrospective study was carried out to find the incidence, clinical profiles and treatment outcome of pulmonary and extrapulmonary tuberculosis patients attending the only Chest Disease Hospital in Srinagar.Methods: A retrospective analysis of 613 patients having EPTB and PTB was undertaken from the chest disease hospital of Government Medical College Srinagar. Demographic characteristics, clinical features and treatment outcome were obtained from medical case records of all patients visiting the hospital for a period of two years from May 2016-May 2018.Results: The study comprised of 613 patients, out of which 365% were having pulmonary TB while 35% were having extrapulmonary TB. Majority of patients (44.5%) in TB group were in age group 10-30 while majority of patients (42%) in EPTB group were in age group 51-70. Males were seen more commonly affected. Majority (90%) of patients in EPTB group had pleural effusion. Majority of patients (71%) were smear positive by ZN staining in PTB group. Majority (90%) of PTB patients in smear negative group were BAL negative. In PTB group 8% were treatment failure while in EPTB group 2% were treatment failure. MDR was seen in 4.2% of total tuberculosis patient while XDR was seen in 0.32% of total patients. Out of treatment failure in PTB group MDR was seen in 64% followed by monoresistance to INH in 30% and XDR in 6%. In EPTB group MDR was seen in 100% of treatment failure. All patients with XDR died. Among the MDR patients majority are on treatment while 12% died, another 12% defaulter while 12% completed treatment.Conclusions: Among evaluated tuberculosis patients, maximum had PTB. Pleural tuberculosis was the most common presentation of EPTB. The study shows male preponderance in both groups. Treatment response was excellent with failure rate of 8% in PTB and 2% in EPTB. Most common cause of failure was MDR. XDR was seen in two patients and both of them died.

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Treatment outcome of extrapulmonary tuberculosis under Revised National Tuberculosis Control Programme

Cited by 42 publications

References 13 publications

Extra-pulmonary tuberculosis: A retrospective study of patients in Accra, Ghana

Extra-pulmonary tuberculosis: A retrospective study of patients in Accra, Ghana

Extrapulmonary tuberculosis in Pakistan- A nation-wide multicenter retrospective study

Tuberculosis: an experience at government chest disease hospital

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