Burden of Tuberculosis in a Private Indian Setting: An Experience

Abstract

Background. Notification of tuberculosis (TB) cases from the private sector to state public health officials is a challenge. This helps to better practices in terms of standard TB care, which includes helping the patients to get right diagnosis, treatment, follow up, and facilitates social support systems. From 2009 to 2014, only 8.4% of total TB cases from the private sector were notified, with a majority being unaccounted for in the country. Multidrug-resistant (MDR) TB is a major challenge which needs to be addressed by all the stake holders. The goal was to assess the burden of TB in private sector, determine the site of disease and estimate drug resistance. Methods. A single center prospective study was conducted in a tertiary care hospital. Patients over 18 years diagnosed with TB from July 2015 to May 2016 were included. Transplant patients and those with hematologic malignancies were excluded. Demographics, diagnostic tests, drug resistance patterns were recorded and analyzed. Results. Two hundred and fifty six (mean age 18-45years) cases were studied. Conclusion. Tuberculosis burden in India is increasing in spite of lot of efforts made to contain it. Diabetes mellitus is one of the risk factors for TB. Extrapulmonary TB was more commonly encountered. Gene Xpert testing is being increasingly used. Drug resistant TB was observed at 5.85%. Isoniazid resistance may be under reported as Isoniazid testing is not routinely performed. Clinicians in the private setting need to improve the reporting of TB. (Table Presented) .