DOI: http://dx.doi.org/10.18203/2349-2902.isj20185477

Changing trends in incidence and clinical spectrum of extra-pulmonary tuberculosis: a 10-year retrospective study in a rural teaching hospital in South India

Sanoop Kumar Sherin Sabu, Vergis Paul, Deepu J. E. Mathew, T. M. Jacob, Celine T. M.

Abstract


Background: EPTB, remains a great mimicker in spite of availability of new diagnostic tools. The data available in different literatures and national record remain inconclusive. This study aims to find the change in incidence and clinical spectrum of EPTB during 10 years in the proposed study center.

Methods: Retrospective, medical records based study, on patients newly diagnosed to have EPTB, at MOSC-MCH, Kolenchery, Kerala, India from 1-01-2006 to 31-12-2015.

Results: Among the 1488 new cases of tuberculosis 665 (44.7%) had EPTB and 823 (55.3%) had pulmonary TB (PTB). There was a consistent rise in annual number of new cases of EPTB from 2007 to 2013. Lymph-node, 31% (n=203) and pleural effusion 26% (n= 126) are common sites. There was female gender predominance in the age group of 18-44 years. Commonest site of lesion in females as well as in males was lymph node TB (n=121, 35.9% and n=82, 25% respectively). Pleural effusion and genital TB showed a male predominance.

Conclusions: Incidence of EPTB shows an increasing trend from 2006 to 2015 in this study which is in contrast to the falling state and national trends. In the global TB reports, India has underestimated TB data between 2000 and 2015. The rising trend of new cases in our study centre can be the impact of immigrant labourers or may be due to increased referred cases to this tertiary centre. Further multicentre studies and studies among the immigrant labourers should be done to evaluate this.


Keywords


Clinical spectrum, Extra pulmonary tuberculosis, The sites of occurrence of EPTB

Full Text:

PDF

References


Park K. Preventive and social medicine. 23rd ed. Jabalpur: M/s Banarsidas Bhanot; 2015.

Central Tuberculosis Division, Government of India. TB India 2015, annual status report, RNTCP.

Available at: https://tbcindia.gov.in/showfile.php?lid=3166.

World Health Organization. Global tuberculosis report 2014, 2014. Available at: http://www.who.int/tb/publications/global_report/en/.

Kumar V, Abbas AK, Aster JC, editors. Robbins basic pathology. 19th ed. Philadephia: Elsevier Saunders; 2013.

Sharma SK, Mohan A. Extrapulmonary tuberculosis. Ind J Med Res. 2004;120(4):316-53.

Horne DJ, Narita M. Extrapulmonary Tuberculosis. BMJ Best Practice found on best practice, 2018. Available at: http://bestpractice.bmj.com/best-practice/monograph/166/basics/epidemiology.html.

Kumar P, Sharma N, Sharma NC, Patnaik S. Clinical profile of tuberculosis in patients with HIV Infection/AIDS. Indian J Chest Dis Allied Sci. 2002;44:159-63.

Kapoor VK. Modern management f abdominal tuberculosis. In: Johnson D Colin, Irving T, editors. Recent advances in surgery. 1st ed. New Delhi: Jaypee Brothers Medical Publishers (p) Ltd; 2013:156-169.

Govindasamy M, Srinivasan T, Varma V, Mehta N, Yadav A, Kumaran V, Nundy S. Biliary tract tuberculosis-a diagnostic dilemma. J Gastrointes Surg. 2011 Dec 1;15(12):2172-7.

Sinhasan SP, Puranik RB, Kulkarni MH. Abdominal tuberculosis may masquerade many diseases. Saudi J Gastroenterol. 2011;17(2):101-3.

Central TB division, Ministry of Health and Family Welfare. RNTCP Training course for Program Manager (Module 1-4) 2011. Available at: https://tbcindia.gov.in/index1.php?lang=1&level=3&sublinkid=4262&lid=2906.

Central TB division, Ministry of Health and Family Welfare. Index-TB Guidelines 2016. 2016. Available at: https://tbcindia.gov.in/showfile.php?lid=3245.

Prakasha SR, Suresh G, D’sa IP, Shetty SS, Kumar SG. Mapping the pattern and trends of extrapulmonary tuberculosis. J Global Infect Dis. 2013 Apr;5(2):54.

Sreeramareddy CT, Panduru KV, Verma SC, Joshi HS, Bates MN. Comparison of pulmonary and extrapulmonary tuberculosis in Nepal-a hospital-based retrospective study. BMC Infect Dis. 2008 Dec;8(1):8.

Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis. 2009 Nov 15;49(9):1350-7.

Arora VK, Gupta R. Trends of extra-pulmonary tuberculosis under revised national tuberculosis control programme: A study from South Delhi. Indian J Tuber. 2006 Apr 1;53(2):77-83.

Joseph MP, Narayana D, Venkiteswaran CS. Study of Domestic Migrant Labour in Kerala. Gulati Institute of Finance and Taxation. Submitted to Labour and Rehabilitation Department Government of Kerala; February, 2013.

Swaminathan S. The End TB strategy. The Hindu Week End. 2016. Available at: https://www.thehindu.com/todays-paper/tp-opinion/The-End-TB-strategy/article15570601.ece

Garzelli C, Lari N, Cuccu B, Tortoli E, Rindi L. Impact of immigration on tuberculosis in a low-incidence area of Italy: a molecular epidemiological approach. Clin Microbiol Infect. 2010;16(11):1691-7

Bunger R, Singh VA, Mengi S, Pathania D, Vohra P. Demographic analysis of extra pulmonary tuberculosis at a tertiary care hospital in north India. Int. J. Life Sci Bt Pharm Res. 2014;3(2250-3137):150-4.