Background:India is one of the high tuberculosis (TB) burden countries in the world. India ranks second in harboring multi drug resistant (MDR)-TB cases. About 50,000 of MDR cases are recorded in retreatment pulmonary TB cases. This study was conducted in a tertiary care facility (Government General and Chest Hospital) in Hyderabad, India.Objectives:Toassess: Proportion of the TB patients having MDR-TB at the initiation of retreatment regimen; the prevalence of isoniazid (INH) resistance in this geographical area.Materials and Methods:An analytical, observational, prospective cohort study of patients attending the out-patient department from December 2010 to March 2011.Results:Sputum samples from 100 patients were subjected to acid fast bacilli (AFB) culture and drug sensitivity testing. Of these, 28 (28%) were MDR-TB, 42 (42%) were non-MDR-TB and 39% being INH resistance.Conclusions:In conclusion, one third of the retreatment pulmonary TB cases attending a tertiary care institute for TB will be MDR-TB at the initiation of treatment and there is a need to include ethambutol in the continuation phase of new TB case treatment in view of high INH resistance.

CitationKandi S, Reddy V, Nagaraja SB. Diagnosis of pulmonary and extra pulmonary tuberculosis: How best is CBNAAT when compared to conventional methods of TB detection? Pulm Res Respir Med Open J. 2017; 4(2): 38-41. doi: 10.17140/ PRRMOJ-4-137 ABSTRACT Background: Globally, India is a home for more than 25% of global Tuberculosis (TB) burden. The sensitivity of smear microscopy and its inability to detect drug resistance limits its impact on TB control. We compared the cartridge-based nucleic acid amplification test (CBNAAT) results for diagnosis of pulmonary and extrapulmonary tuberculosis with the conventional methods like sputum smear and solid culture examination. Methods: A descriptive study was conducted at Government General and Chest Hosptial, Hyderabad, India during 2014 to 2016. The study population included all the pulmonary and extrapulmonary presumptive TB cases who were subjected for further investigations. Results: Of the two hundred samples received, 110 (55%) were sputum samples and 90 (45%) were extrapulmonary samples. For pulmonary samples, the sensitivity and specificity for CB-NAAT samples were 79.2% and 89.5% respectively; while that for sputum smear were 41.5% and 98.2% respectively. For extrapulmonary samples, the sensitivity and specificity for CB-NAAT samples were 85.7% and 93.5% respectively; while that for sputum smear were 60.7% and 100% respectively. Conclusion: CBNAAT is one of the rapid diagnostic tests available in the country and it should be routinely used under the public and private health sector effectively to detect a tuberculosis case.

SettingA tertiary health care facility (Government General and Chest hospital) in Hyderabad, India.ObjectivesTo assess a) the extent of compliance of specialists to standardized national (RNTCP) tuberculosis management guidelines and b) if patients on discharge from hospital were being appropriately linked up with peripheral health facilities for continuation of anti-Tuberculosis (TB) treatment.MethodsA descriptive study using routine programme data and involving all TB patients admitted to inpatient care from 1st January to 30th June, 2010.Results and ConclusionsThere were a total of 3120 patients admitted of whom, 1218 (39%) required anti-TB treatment. Of these 1104 (98%) were treated with one of the RNTCP recommended regimens, while 28 (2%) were treated with non-RNTCP regimens. The latter included individually tailored MDR-TB treatment regimens for 19 patients and adhoc regimens for nine patients. A total of 957 (86%) patients were eventually discharged from the hospital of whom 921 (96%) had a referral form filled for continuing treatment at a peripheral health facility. Formal feedback from peripheral health facilities on continuation of TB treatment was received for 682 (74%) patients. In a tertiary health facility with specialists the great majority of TB patients are managed in line with national guidelines. However a number of short-comings were revealed and measures to rectify these are discussed.

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