Clinico-Epidemiological Profile of Extra-pulmonary Tuberculosis in Central India
Keywords:
Extrapulmonary Tuberculosis, Lymph node TB, Revised National Tuberculosis Control Programme
Abstract
Introduction: Tuberculosis (TB) remains a major global health issue. India being highest TB burden country needs concern. It was found that the percentage of patients with EPTB was more in tertiary care centres of India, ranging from 30% to 53%. The primary objective of this study was to describe the basic demographic, clinical characteristics and risk factors of Extrapulmonary Tuberculosis in patients, registered at DOTS centre of tertiary care teaching hospital.
Materials and Methods: This is a retrospective, record-based study of patients of EPTB, at the LN Medical College and Hospital, Bhopal, from 1st January 2012 to 30th June 2014.
Results: Among 491 cases registered for treatment of all forms of tuberculosis, 361(73.53%) had PTB and 130 (26.47%) had EPTB. The ratio of percentage EPTB: PTB is 1:3.6. Commonest type of EPTB was found in cases of lymph nodes and lymphatic (30.76%), followed by TB in pleural cavity (23.03%). Among different age groups studied, the age group of 20-39 years had the highest proportion of EPTB both in males and females which is the economically productive population of society.
Conclusion: The frequency of EPTB in this study was higher (26.47%) with the highest proportion in lymph node (30.76%). The burden of EPTB is more among the productive age group, moreover, being male, young adults and having associated diabetes mellitus were significant risk factors for patient being EPTB positive.
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References
1. "Tuberculosis Fact sheet N°104". World Health Organization. November 2010. Retrieved 26 July 2011. http://www.who.int/mediacentre/factsheets/fs104/en/
2. Global Tuberculosis Control 2014, WHO, Geneva, 2014.www.who.int/tb/publications/global_report/en/
3. District- wise performance of RNTCP .TB India 2011.114–5. http://www.tbcindia.org ISBN 81-902652-5-3.
4. TB Statistics for India –TBFacts.org 2012. Available at: http://www.tbfacts.org/tb-statistics-india.html.
5. Prakasha SR, Suresh G, D’sa IP, Shetty SS, Kumar SG. Mapping the Pattern and Trends of Extrapulmonary Tuberculosis. J Glob Infect Dis. 2013 Apr;5(2):54-9. doi: 10.4103/0974-777X.112277. [PubMed]
6. Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res.2004; 120:316–53. Indian J Med Res. 2004 Oct;120(4):316-53.PMID:15520485. [PubMed]
7. Narain JP, Lo YR. Epidemiology of HIV-TB in Asia. Indian J Med Res. 2004 Oct;120(4):277-89. [PubMed]
8. PriyaKandola, Laxman S. Meena. Extra pulmonary tuberculosis: Overview manifestations, diagnosisand treatment techniques. Adv. Mater. Rev. 2014; 1(1): 13-19doi: 10.5185/amr.2014.1003.
9. Arora VK, Chopra KK: Extrapulmonary tuberculosis. Indian J Tuberc. 2007 Oct;54(4):165-7. [PubMed]
10. TB India 2007- RNTCP status report. Central Tuberculosis Division, New Delhi.2007 March;106.http://www.tbcindia.org ISBN 81-902652-2-9.
11. Yohannes Zenebe, Belay Anagaw,WogahtaTesfay, et al. Smear positive extra pulmonary tuberculosis disease at University of Gondar Hospital, Northwest Ethiopia. BMC Research Notes 2013, 6:21.doi:10.1186/1756-0500-6-21.
12. Yang Z, Kong Y, Wilson F, Foxman B, Fowler AH, Marrs CF, Cave MD, Bates JH. Identification of risk factors for extrapulmonary tuberculosis. Clin Infect Dis. 2004 Jan 15;38(2):199-205. Epub 2003 Dec 19. doi: 10.1086/380644.
13. Chandir S, Hussain H, Salahuddin N, Amir M, Ali F, Lotia I: Extrapulmonary tuberculosis: a retrospective review of 194 cases at a tertiary care hospital in Karachi, Pakistan.J Pak Med Assoc 2010 Feb;60(2):105-9. [PubMed]
14. Peto HM, Pratt RH, Harrington TA, et al. Epidemiology of extrapulmonary tuberculosis in the United States,1993-2006.Clin Infect Dis. 2009 Nov 1;49(9):1350-7. doi: 10.1086/605559. [PubMed]
15. Selami Gunal, Zhenhua Yang, Mansi Agarwal, Riza Durmaz et al: Demographic and microbial characteristics of extrapulmonary tuberculosis cases diagnosed in Malatya, Turkey, 2001-2007. BMC Public Health 2011, 11:154 doi:10.1186/1471-2458-11-154.
16. Holmes CB, Hausler H, Nunn P. A review of sex differences in the epidemiology of tuberculosis. Int J Tuberc Lung Dis 1998; 2(2):96–104. [PubMed]
17. Hudelson P. Gender differentials in tuberculosis: the role of socioeconomic and cultural factors. Tuber Lung Dis. 1996 Oct;77(5):391-400.
18. Adrian O, Jennifer C, Philip CH, Leah C, Gonzalez MW, Robert MJ, Charles LD. Molecular Epidemiological Assessment of Extra pulmonary Tuberculosis in San Francisco. ClinInfe Dis. 2004;38(1):25–31. doi: 10.1086/380448.
19. Memish, Ziad Ahmed et al. “Incidence of and Risk Factors Associated with Pulmonary and Extra-Pulmonary Tuberculosis in Saudi Arabia (2010–2011).” Ed. Angelo A. Izzo.PLoS ONE 9.5 (2014): e95654. PMC. Web. 5 Apr. 2015..doi: 10.1371/journal.pone.0095654. [PubMed]
20. Fiske CT, Griffin MR, Erin H,et al: Black race, sex and extra pulmonary tuberculosis risk: an observational study. BMC Infec Dis 2010, 10:16.doi:10.1186/1471-2334-10-16. [PubMed]
21. Sreeramareddy CT, Panduru KV, Verma SC, et al. Comparison of pulmonary and extrapulmonary tuberculosis in Nepal-a hospital-based retrospective study. BMC Infect Dis. 2008;8:8.doi: 10.1186/1471-2334-8-8. [PubMed]
22. Cailhol J, Decludt B, Che D. Sociodemographic factors that contribute to the development of extrapulmonary tuberculosis were identified. J Clin Epidemiol. 2005;58:1066–71. doi: 10.1016/j.jclinepi.2005.02.023. [PubMed]
23. H.Yang, S.K. Field, D.A. Fisher, R.L. Cowie. Tuberculosis in Calgary, Canada, 1995-2002: site of disease and drug susceptibility. Int J Tuberc Lung Dis;2005; 9 (3): 288-293.
24. Arora VK, Gupta R. Trends of extra-pulmonary tuberculosis under Revised National Tuberculosis Control Programme: A study from South Delhi. Indian J Tuberc. 2006;53:77–83.
25. Rai DK, Bisht RS, Sikarwar V, Upadhyay SK. Clinicoepidemiological trend of tuberculosis in garhwal region.IOSR Journal of Pharmacy. 2012. 2(5) : 39-43.
26. Xinyu Zhang, Aase B. Andersen, TroelsLillebaek, ZazaKamper-Jørgensen, VibekeØstergaard Thomsen, Karin Ladefoged, Carl F. Marrs, Lixin Zhang, Zhenhua YangEffect of Sex, Age, and Race on the Clinical Presentation of Tuberculosis: A 15-Year Population-Based Study. Am J Trop Med Hyg. 2011 Aug;85(2):285-90. doi: 10.4269/ajtmh.2011.10-0630.
27. Knut Lönnroth , Mario Raviglione. Global epidemiology of Tuberculosis: Prospects for control. Semin Respir Crit Care Med 2008 Oct 22;29(5):481-91.
28. UNAIDS.AIDS epidemic update 2007 available from URL ttp://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf
29. District epidemiological profiling Fact Sheet Vol-1, December 2012. [PubMed]
30. Lawn, SD; Zumla, AI (2 July 2011). "Tuberculosis". Lancet. 2011 Jul 2;378(9785):57-72. doi: 10.1016/S0140-6736(10)62173-3. [PubMed]
31. Gupta S, Shenoy VP, Bairy I, Srinivasa H, Mukhopadhyay C. Diabetes mellitus and HIV as co-morbidities in tuberculosis patients of rural south India. J Infect Public Health. 2011 Aug;4(3):140-4. doi: 10.1016/j.jiph.2011.03.005. [PubMed]
32. Viswanathan V, Kumpatla S, Aravindalochanan V, Rajan R, Chinnasamy C, et al. Prevalence of Diabetes and Pre-Diabetes and Associated Risk Factors among Tuberculosis Patients in India. PLoS ONE 2012.7(7): e41367. [PubMed]
33. Van Zyl-Smit RN, Brunet L, Pai M, Yew WW. The convergence of the global smoking, COPD, Tuberculosis, HIV, and respiratory infection epidemics.Infectious disease clinics of North America. 2010;24(3):693-703. doi:10.1016/j.idc.2010.04.012.
34..Stefan DC, Kruis AL, Schaaf HS, Wessels G. Tuberculosis in oncology patients. Ann Trop Paediatr. 2008;28:111–6. http://dx.doi.org/10.1179/146532808X302125.
2. Global Tuberculosis Control 2014, WHO, Geneva, 2014.www.who.int/tb/publications/global_report/en/
3. District- wise performance of RNTCP .TB India 2011.114–5. http://www.tbcindia.org ISBN 81-902652-5-3.
4. TB Statistics for India –TBFacts.org 2012. Available at: http://www.tbfacts.org/tb-statistics-india.html.
5. Prakasha SR, Suresh G, D’sa IP, Shetty SS, Kumar SG. Mapping the Pattern and Trends of Extrapulmonary Tuberculosis. J Glob Infect Dis. 2013 Apr;5(2):54-9. doi: 10.4103/0974-777X.112277. [PubMed]
6. Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res.2004; 120:316–53. Indian J Med Res. 2004 Oct;120(4):316-53.PMID:15520485. [PubMed]
7. Narain JP, Lo YR. Epidemiology of HIV-TB in Asia. Indian J Med Res. 2004 Oct;120(4):277-89. [PubMed]
8. PriyaKandola, Laxman S. Meena. Extra pulmonary tuberculosis: Overview manifestations, diagnosisand treatment techniques. Adv. Mater. Rev. 2014; 1(1): 13-19doi: 10.5185/amr.2014.1003.
9. Arora VK, Chopra KK: Extrapulmonary tuberculosis. Indian J Tuberc. 2007 Oct;54(4):165-7. [PubMed]
10. TB India 2007- RNTCP status report. Central Tuberculosis Division, New Delhi.2007 March;106.http://www.tbcindia.org ISBN 81-902652-2-9.
11. Yohannes Zenebe, Belay Anagaw,WogahtaTesfay, et al. Smear positive extra pulmonary tuberculosis disease at University of Gondar Hospital, Northwest Ethiopia. BMC Research Notes 2013, 6:21.doi:10.1186/1756-0500-6-21.
12. Yang Z, Kong Y, Wilson F, Foxman B, Fowler AH, Marrs CF, Cave MD, Bates JH. Identification of risk factors for extrapulmonary tuberculosis. Clin Infect Dis. 2004 Jan 15;38(2):199-205. Epub 2003 Dec 19. doi: 10.1086/380644.
13. Chandir S, Hussain H, Salahuddin N, Amir M, Ali F, Lotia I: Extrapulmonary tuberculosis: a retrospective review of 194 cases at a tertiary care hospital in Karachi, Pakistan.J Pak Med Assoc 2010 Feb;60(2):105-9. [PubMed]
14. Peto HM, Pratt RH, Harrington TA, et al. Epidemiology of extrapulmonary tuberculosis in the United States,1993-2006.Clin Infect Dis. 2009 Nov 1;49(9):1350-7. doi: 10.1086/605559. [PubMed]
15. Selami Gunal, Zhenhua Yang, Mansi Agarwal, Riza Durmaz et al: Demographic and microbial characteristics of extrapulmonary tuberculosis cases diagnosed in Malatya, Turkey, 2001-2007. BMC Public Health 2011, 11:154 doi:10.1186/1471-2458-11-154.
16. Holmes CB, Hausler H, Nunn P. A review of sex differences in the epidemiology of tuberculosis. Int J Tuberc Lung Dis 1998; 2(2):96–104. [PubMed]
17. Hudelson P. Gender differentials in tuberculosis: the role of socioeconomic and cultural factors. Tuber Lung Dis. 1996 Oct;77(5):391-400.
18. Adrian O, Jennifer C, Philip CH, Leah C, Gonzalez MW, Robert MJ, Charles LD. Molecular Epidemiological Assessment of Extra pulmonary Tuberculosis in San Francisco. ClinInfe Dis. 2004;38(1):25–31. doi: 10.1086/380448.
19. Memish, Ziad Ahmed et al. “Incidence of and Risk Factors Associated with Pulmonary and Extra-Pulmonary Tuberculosis in Saudi Arabia (2010–2011).” Ed. Angelo A. Izzo.PLoS ONE 9.5 (2014): e95654. PMC. Web. 5 Apr. 2015..doi: 10.1371/journal.pone.0095654. [PubMed]
20. Fiske CT, Griffin MR, Erin H,et al: Black race, sex and extra pulmonary tuberculosis risk: an observational study. BMC Infec Dis 2010, 10:16.doi:10.1186/1471-2334-10-16. [PubMed]
21. Sreeramareddy CT, Panduru KV, Verma SC, et al. Comparison of pulmonary and extrapulmonary tuberculosis in Nepal-a hospital-based retrospective study. BMC Infect Dis. 2008;8:8.doi: 10.1186/1471-2334-8-8. [PubMed]
22. Cailhol J, Decludt B, Che D. Sociodemographic factors that contribute to the development of extrapulmonary tuberculosis were identified. J Clin Epidemiol. 2005;58:1066–71. doi: 10.1016/j.jclinepi.2005.02.023. [PubMed]
23. H.Yang, S.K. Field, D.A. Fisher, R.L. Cowie. Tuberculosis in Calgary, Canada, 1995-2002: site of disease and drug susceptibility. Int J Tuberc Lung Dis;2005; 9 (3): 288-293.
24. Arora VK, Gupta R. Trends of extra-pulmonary tuberculosis under Revised National Tuberculosis Control Programme: A study from South Delhi. Indian J Tuberc. 2006;53:77–83.
25. Rai DK, Bisht RS, Sikarwar V, Upadhyay SK. Clinicoepidemiological trend of tuberculosis in garhwal region.IOSR Journal of Pharmacy. 2012. 2(5) : 39-43.
26. Xinyu Zhang, Aase B. Andersen, TroelsLillebaek, ZazaKamper-Jørgensen, VibekeØstergaard Thomsen, Karin Ladefoged, Carl F. Marrs, Lixin Zhang, Zhenhua YangEffect of Sex, Age, and Race on the Clinical Presentation of Tuberculosis: A 15-Year Population-Based Study. Am J Trop Med Hyg. 2011 Aug;85(2):285-90. doi: 10.4269/ajtmh.2011.10-0630.
27. Knut Lönnroth , Mario Raviglione. Global epidemiology of Tuberculosis: Prospects for control. Semin Respir Crit Care Med 2008 Oct 22;29(5):481-91.
28. UNAIDS.AIDS epidemic update 2007 available from URL ttp://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf
29. District epidemiological profiling Fact Sheet Vol-1, December 2012. [PubMed]
30. Lawn, SD; Zumla, AI (2 July 2011). "Tuberculosis". Lancet. 2011 Jul 2;378(9785):57-72. doi: 10.1016/S0140-6736(10)62173-3. [PubMed]
31. Gupta S, Shenoy VP, Bairy I, Srinivasa H, Mukhopadhyay C. Diabetes mellitus and HIV as co-morbidities in tuberculosis patients of rural south India. J Infect Public Health. 2011 Aug;4(3):140-4. doi: 10.1016/j.jiph.2011.03.005. [PubMed]
32. Viswanathan V, Kumpatla S, Aravindalochanan V, Rajan R, Chinnasamy C, et al. Prevalence of Diabetes and Pre-Diabetes and Associated Risk Factors among Tuberculosis Patients in India. PLoS ONE 2012.7(7): e41367. [PubMed]
33. Van Zyl-Smit RN, Brunet L, Pai M, Yew WW. The convergence of the global smoking, COPD, Tuberculosis, HIV, and respiratory infection epidemics.Infectious disease clinics of North America. 2010;24(3):693-703. doi:10.1016/j.idc.2010.04.012.
34..Stefan DC, Kruis AL, Schaaf HS, Wessels G. Tuberculosis in oncology patients. Ann Trop Paediatr. 2008;28:111–6. http://dx.doi.org/10.1179/146532808X302125.
CITATION
DOI: 10.17511/ijmrr.2015.i2.046
Published: 2015-03-31
How to Cite
1.
Kumar Shrivastava A, Brahmachari S, Pathak P, Kumar R, Sainia T, Patel U, Mandil A. Clinico-Epidemiological Profile of Extra-pulmonary Tuberculosis in Central India. Int J Med Res Rev [Internet]. 2015Mar.31 [cited 2024Nov.8];3(2):223-30. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/214
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