Diagnostic Procedures, Diagnoses, and Treatment Outcomes of Patients with Presumptive Tuberculosis Pleural Effusion in Uzbekistan

Abstract

Tuberculosis (TB) pleural effusion (TPE) is the second most common manifestation of extrapulmonary TB (EPTB), which remains a great diagnostic challenge worldwide. In Uzbekistan, there has been no formal evaluation of the actual practices of diagnosing and treating TPE. Our cohort study therefore aimed to describe the frequency and types of different diagnostic procedures of TPE during 2017–2018 and assess the association of baseline characteristics and establish diagnostic methods with TB treatment outcomes. In total, 187 patients with presumptive TPE were assessed, and 149 had a confirmed diagnosis of TPE (other diagnoses included cancer n = 8, pneumonia n = 17, and 13 cases were unspecified). TB was bacteriologically confirmed in 22 (14.8%), cytologically confirmed in 64 (43.0%), and histologically confirmed in 16 (10.7%) patients. Hepatitis was the only co-morbidity significantly associated with unsuccessful treatment outcomes (RR 4.8; 95%CI: 1.44–15.98, p value 0.011). Multivariable regression analysis showed that drug-resistant TB was independently associated with unsuccessful TB treatment outcome. (RR 3.83; 95%CI: 1.05–14.02, p value 0.04). Multidisciplinary approaches are required to maximize the diagnostic accuracy of TPE and minimize the chances of misdiagnosis. TPE patients with co-infections and those with drug resistance should be more closely monitored to try and ensure successful TB treatment outcomes.

Epidemiological Study of Prevalence TB in Iraq

“…In this experiment, 92.8 percent of the total sputum samples showed positive results for pulmonary tuberculosis on a smear test; the fact that it poses a danger of infecting others by droplet or airborne transmission 16,17 is one reason why it could be considered a source of community contagiousness. In addition, the findings demonstrated that patients with EPTB were more likely to have pleural infections than any other type of infection, which is consistent with (9,18) in Iraq and (19,20) in Iran and Uzbekistan; further research has found that lymph nodes are to blame for nearly half of the cases of extra-pulmonary tuberculosis (EPTB) in Iraqi Kurdistan 21 and in Turkey 22 . For instance, the genitourinary system and the skin were the two most common sites of infection in Hong Kong 23 , but in the United States, bone and joint infections were more prevalent 24 .…”