A retrospective study on Tuberculous Lymphadenitis; A retrospective finding from multicenters referal hospitals

Abstract

Background Extra-pulmonary tuberculosis (EPTB) represents about 14% of all cases of tuberculosis (TB) in Malaysia. The aims of the study include evaluation of socio-demographic factors, clinical manifestations, co-morbidities among patients with Tuberculous Lymphadenitis and their treatment outcomes.Methods The retrospective study was conducted from 2006 to 2008. Data on socio-demographic along with histopathological results were collected. Signs and symptoms were also recorded from TB registers, treatment cards and TB medical personal files using standard data collection tool. Among multiple variables significant factors identified by univariate analysis, were included in multivariate logistic regression to estimate the odds ratios (ORs) with the 95% confidence intervals (CIs). The statistically significant p value was considered as < 0.05.Results There were 348 (57%) males and on the other hand 262 (43%) females which shows almost equal incidence rate of Lymphadenitis in both genders. Mean age was found as 34.3 ± 14.6 years were majorly reported with positive diagnosis. 196 (32.1%) Malay was found with Tuberculous lymphadenitis followed by Chinese population of 148 (24.3%). Geographically from 386 (63.3%) urban population were found positive for lymphadenitis and over 224 (36.7%) of rural region. treatment outcome was observed 444 (72.8%) with successful treatment. WHO states the types of treatment failures and accordingly 85 (13.9%) patients were continued with the therapy that can be due to non-compliance or relapse of Tb. Among unsuccessful outcomes 194 patients of age group 26 -35 years, 65 (33.5%) were reported and 38 (29.7%) patients out of 128 between 16 – 25 years. Blood results showed erythrocyte sedimentation rate greater than 10 in 280 (45.9%) patients. Therefore, among 280 there were 115 (41.1%) patients found to have unsuccessful treatment showing strong association with p-value of <0.001.Conclusion Finding signifies that effect of weight loss on poor treatment outcomes` and active screening measures for patients with comorbidities are therefore recommended in patients with Tb lymphadenitis along with improvements in the diagnosis and early management of co-morbidities complications. As young age group were found to have poor or unsuccessful treatment outcomes and required aggressive strategy together with educating patients can further increase the treatment success rate.