A study of extra-pulmonary tuberculosis and its outcome

Abstract

Background: Pulmonary tuberculosis being the predominant manifestation of the disease extra-pulmonary sites can also involve as a result of dissemination from a chief focus. Extra- pulmonary tuberculosis is more common in HIV cases. The present study aims to determine the presentation and outcome of patients with extra-pulmonary tuberculosis treated with DOTS and to assess any difference in outcome of treatment in HIV positive extra-pulmonary tuberculosis.Methods: Data was collected from cases of tuberculosis patients diagnosed and treated under DOTS at Sri Siddhartha Medical College for the period of one year (during 2015). We evaluated extra-pulmonary cases and recorded sites of involvement in order of frequency. We also studied treatment outcome by recording as per definitions given by the WHO and also evaluated any difference in outcome of extra-pulmonary tuberculosis disease with HIV co-infection.Results: Extra-pulmonary cases accounted for 30.5% of total TB cases. Among 224 cases of extra-pulmonary TB studied, 136 (60.7%) were males and 88 (39.3%) were females. Most common site of extra-pulmonary tuberculosis was pleura (29.9%) followed by meninges (22.5%), abdomen (19.6%) and lymph node (10.7%) tuberculosis. Among these patients 82.2% completed treatment, 7.5% were defaulted, 9.9% died and 0.4% treatment failure. The most common reason for default was irregular treatment (29.5%) followed by alcohol abuse (23.5%). Among 8 HIV reactive patients, 5 patients completed treatment and the remaining 3 patients died during the course of treatment.Conclusions: Extra-pulmonary Tuberculosis accounts for 30.5% of the total cases studied. Pleura is most common site of extra-pulmonary TB in our study. Treatment irregularities and alcohol abuse are the two most common reasons for default.   Co-infection with HIV seems to have a poor outcome on patients with extra-pulmonary TB and needs to be studied in large number of samples.