Prevalence, clinical profile, and treatment outcomes of adult patients diagnosed with disseminated tuberculosis seen at University of the Philippines Manila-Philippine General Hospital Tuberculosis Directly Observed Treatment Short Course (TB-DOTS) Clinic

ABSTRACT

OBJECTIVE: To determine the prevalence, demographic, clinical profile, diagnostic and treatment outcomes of adult patients diagnosed with disseminated tuberculosisMETHODS: This is a cross sectional study of patients referred to the UP-PGH TB DOTS clinic with a diagnosis of disseminated TB from January 2011 to December 2015.RESULTS: The prevalence of disseminated tuberculosis was 1.7 %.Mean age at diagnosis was 33.9 years (range 19-64 years) with a male female ratio of 11. The most common comorbidity was HIV (5.8%). The mean duration of symptoms before initial consult was 281 days (SD 510.7). The most common presenting symptoms were abdominal pain (19%), back pain (13%), and abdominal enlargement (11%). The lungs (86%) are still the most commonly involved site, followed by the gastrointestinal tract (22%) and the vertebra (27%). Majority were started with Category I treatment regimen (54%, 37 patients). Of the 68 patients, only 16% (11 patients) continued follow-up at PGH; all had documented treatment completion.CONCLUSION: Patients with disseminated tuberculosis are young and majority had no comorbid illness. They have long latency of symptoms prior to diagnosis, and usually present with nonpulmonary symptoms despite high evidence of pulmonary involvement. To date, this is the largest local study on disseminated TB known to the authors.