Epidemiology and effects of sociodemographic factors on extrapulmonary tuberculosis in Ambala, India.

BACKGROUND: An ambitious plan was set into motion with the aim of TB elimination from India in 2025. To achieve this, it is high time to give emphasis on other prevalent forms of TB, such as extra pulmonary TB (EPTB). OBJECTIVES: The study aims to discern the differences in patient characteristics and management practices between pulmonary TB and EPTB using data from district Ambala. METHODS: This retrospective study used data of 12,985 TB patients from district Ambala, India. The differences in patient characteristics and management practices between pulmonary TB and EPTB were analyzed using the NIKSHAY database. RESULTS: In the studied population, extra pulmonary TB (EPTB) formed 29.7% of all TB cases. Among all EPTB cases, pleural TB was found to be the most common form, accounting for 27%. The study also revealed that female gender, young age, non-diabetic status, and high BMI were associated with an increased propensity to have EPTB. Interestingly, unlike pulmonary TB, which had increased odds for contracting the disease in diabetic individuals (OR - 2.02), there were no increased odds for contracting EPTB in diabetic individuals. However, HIV infection significantly increased the odds for both pulmonary TB and EPTB. The results also showed diagnostic discrepancies between the private and public sectors, along with a low microbiological confirmation rate of 7.1% in EPTB cases. CONCLUSION: The study highlights the importance of focusing on EPTB in addition to pulmonary TB for effective TB elimination in India. The differences in patient characteristics and management practices warrant further investigation and targeted interventions for both forms of the disease. Efforts should be made to improve diagnostic accuracy and reduce discrepancies between the private and public sectors.

Comparison of Imaging Severity Between Vaccinated and Unvaccinated COVID-19 Patients: Perspective of an Indian District.

BACKGROUND: Extensive vaccination drives undertaken globally helped in the fight against the coronavirus disease 2019 (COVID-19) pandemic, but different nations adopted different vaccination policies to tackle the disease. The vaccination drive in India began with the administration of two different vaccines: Covishield and Covaxin. We assessed the effect of vaccination status on imaging severity in patients with positive COVID-19 reverse transcription-polymerase chain reaction (RT-PCR)/antigen tests. METHOD: This was a single-center retrospective observation analysis carried out over three months between March 1, 2021, to May 31, 2021. Data access was provided by the District Hospital Review Board (DHRB) and the Department of Health (DOH), District Ambala, Haryana. Appropriate statistical tools were used to analyze the data. Statistical Package for Social Sciences (SPSS) 26.0 and Python 3.9 were used for statistical analysis and visualization, and a p-value of less than 0.05 was considered statistically significant. RESULTS: The total sample size of the study was 1,316, out of which 371 (28.2%) were vaccinated and 945 (71.8%) were not vaccinated. The mean age of the study participants was 49.6 ± 15.7 years. Seven hundred ninety-seven (60.6%) participants were male, while 519 (39.4%) participants were female. A statistically significant reduction was observed in the computed tomography severity score (CTSS) of the vaccinated population compared to the non-vaccinated group (χ2 = 74.3, p < 0.001). Vaccination led to a statistically significant decrease in mean CTSS across all lung lobes. CONCLUSION: Emerging COVID-19 variants challenge the effect of available vaccines, with different nations adopting different vaccination strategies to deal with the ongoing health problem. CTSS was employed as an objective marker to study the disease severity and effect of vaccination. Vaccination resulted in a significant reduction in CTSS seen on high-resolution computed tomography (HRCT) chest scans. There was a significant decrease in the incidence of severe COVID-19 pneumonia among vaccinated individuals. We need more observational data to corroborate the efficacy of vaccines presented in the randomized trials. Sharing such data between different nations can help us adopt a unifying vaccination strategy and decrease the impact of COVID-19 in subsequent disease waves.