ABSTRACT
Introduction: Extra pulmonary form of tuberculosis is an important public health disease which cannot be ignored because of its low transmissibility. Data on the exact burden of the disease in developing countries is scarce. Aim: To assess the burden of the disease in a tertiary care hospital of India. To study the clinical trends in the disease, and the utility of various diagnostic modalities for its diagnosis. To identify the Mycobacterial species and perform drug susceptibility test. Materials and Methods: A cross sectional study was carried out for a period of two years. A total of one hundred and forty seven samples were tested for extrapulmonary tuberculosis using a combination of bacteriological, cytological, histological and biochemical techniques to achieve proper diagnosis of the disease. Results: Young adults and females predominated in the study group and positive cases. Microbiologically, 26% of the specimens were positive. Eighteen percent of them were found to be culture positive for M. tuberculosis. Smear by Ziehl Neelsen stain was positive in 9%. A combination of culture media both solid and liquid maximized the yield of Mycobacteria. Lymph node tuberculosis was found to be the predominant type followed by others. Fifteen percent of the strains were found to be resistant to the first line drugs used in treatment of tuberculosis. Cytology and biochemical findings were found to be less specific in diagnosis of extrapulmonary tuberculosis. Conclusion: Extrapulmonary form of tuberculosis is seen in significant number of the suspects. Hence, attention should be paid towards its proper and early diagnosis followed by rational management, as if neglected may lead to associated complications and sequalae.
ABSTRACT
Introduction: The revised national tuberculosis control program of India has been able to reduce the disease burden significantly. Despite; TB continues to affect 40% of our population. To achieve the desired goal of NSP {national strategic plan} 2012-2017 we need to have a focused approach on the disease prevalence and the most vulnerable. Aim: To estimate the burden of tuberculosis both pulmonary and extra pulmonary in non HIV patients at a tertiary care hospital in Hyderabad Telangana state South India. Materials and Methods: Over a period of two years from Jan.2013- Jan.2015 a total of two hundred and twenty six specimens, seventy eight from pulmonary and one hundred forty eight from extra pulmonary tuberculosis suspects were processed by various methods to achieve diagnosis. Results: Microbiologically the disease was observed in 25% of the studied subjects. Pulmonary tuberculosis accounted for 10% and extra pulmonary in 15%. Overall smear by ZN stain was positive in 17% and culture in 20%. Cytology could detect disease in 67% of the suspects. Biochemical findings were insignificant. Drug resistance was noted in 4.4% of the cases. Drug resistance and MDR tuberculosis was more common in pulmonary form than in extra pulmonary. Females dominated both in the suspect’s and culture confirmed cases as 53% & 76% respectively. The most affected age group for extra pulmonary disease remained as 6-35 years for both the sexes. In case of pulmonary tuberculosis it was noted as 36-50 years for men. Conclusion: TB affects one third of the suspects. In the present study EPTB has exceeded PTB in the proportion of the laboratory confirmed suspects of tuberculosis. Both the forms of disease are more common in females and young age which needs to be prioritized in the control program to achieve the desired target of NSP.