A study of clinical characteristics and trend of different types of tuberculosis in coastal South India

Abstract

Background: Tuberculosis (TB) is an infectious disease caused by a bacterium, Mycobacterium tuberculosis. The prevalence and the mortality due to tuberculosis are reducing in India, with an increasing number of suspects being examined and treated under Revised National Tuberculosis Control Program (RNTCP). Aim: The primary objective of this study was to describe the basic demographic, clinical characteristics, trends of various types of tuberculosis and program specified treatment protocols of patients registered for TB treatment in this single center attached to medical college hospital under RNTCP. Materials and Methods: This was a retrospective, record-based study of patients of all types of tuberculosis from January 1995 to December 2010 in all age groups, evaluated at K. S. Hegde Medical College and Hospital, Deralakatte, Mangalore, Karnataka, India. Results: A total of 1058 cases were registered and treated under Directly Observed Treatment Short-course (DOTS) during this period. Males (689, 65.12%) contributed to more number of cases than females (369, 34.88%). Of 1058 cases, 400 (37.81%) were found to be smear positive and among them 297 (74.25%) were males and 103 (25.75%) were females. Among 400 smear positive cases, 322 were new smear positive cases and 78 were Re-treatment Smear Positive cases. The Sputum Positive Ratio was ranging between 7.8% and 23% during the study period. 621 cases (58.7%) were classified as Pulmonary and 437 (41.3%) were classified as Extra Pulmonary. Among 621 Pulmonary cases, 221 (35.59%) were treated according to radiological criteria alone (X-ray positive alone). 778 cases received Cat-I treatment, 135 cases received Cat-II treatment, and 141 cases received Cat-III treatment. CXR positive+ EPTB cases contributed to 62.2% (n = 658) of total tuberculosis cases registered for treatment. Conclusion: High proportion of TB patients with EP-TB and its increasing trend along with higher reporting of sputum smear-negative PTB is a major concern for the health authorities in this area.

Clinical Profile, Drug Utilization Pattern and Adverse Drug Reactions of Anti-tubercular Drugs at DOTS Center in a Tertiary Hospital

“…24 Nearly half of the patients were smear positive for AFB. This was consistent with a study conducted by Priyadarshini et al 18 In contrast to our finding, 37.81% TB patients were found to be smear positive by Prakasha et al 10 First line ATD were given to most of the patients in our study. This shows low prevalence of drug resistance in our study.…”

“…ATD are not free from ADR and may cause significant reactions both in severity & quantity leading to abstinence from therapy, prolonged hospital stay and even death. 9 Our study found that more males were affected by TB and similar findings were also reported by Prakasha et al 10 This is probably due to the fact that males, who are usually working are being commonly exposed to the TB bacillus more than females. This may also be due to easy access to the diagnostic and treatment services among male compared to female.…”

“…This finding was in accordance with that of Prakasha et al in which 58.7% cases were PTB. 10 Similar findings were also reported by Priyadarshini et al 18 However, Thakur et al had reported a high prevalence (80.3%) of PTB. 19 Tubercular lymphadenitis was the most common type of EPTB in our study and similar findings were also reported by Thakur et al in which lymph node was most commonly involved.…”

“…19 Pleural TB was most the common type of EPTB in other reports. 10,20 Although PTB is the most common form, EPTB also causes significant morbidity and mortality. Bone TB has been suggested as an important cause of vertebral osteomyelitis and it is a common site of EPTB.…”

Trend of sputum smear positivity among presumptive tuberculosis cases visiting respiratory disease centre of Western Maharashtra, India

“…11 Studies done in India shows similar gender distribution pattern having a wide sex gap with male patients outnumbering female patients. 15,16 Our study findings are in agreement with gender distribution studies done in Zimbabwe 17 and Malawi. 18 Women often remain under-notified by public health authority and undiagnosed female host may serve a potential source of latent infection.…”