Descriptive study of tuberculosis trend at a tertiary care centre in Marathwada region

 

Avinash Ramrao Lamb¹, Vijaykumar Ramappa Kapse^2*

 

¹Associate Professor, Department of Pulmonary Medicine, Government Medical College, Aurangabad, Maharashtra, INDIA.

 

Abstract              Background: India accounts for the highest proportion of global burden of disease with around one-fifth (21%) of the global incidence of the disease contributed by India. It is supposed that the number of new tuberculosis cases detected by the positive sputum for acid-fast bacilli represent just more than fifty percent of the existing TB cases. There are reports from studies done in India which show a high percentage of sputum-negative pulmonary tuberculosis as well as extrapulmonary tuberculosis cases. The present study describes the tuberculosis trends in terms of sputum-positive and sputum-negative pulmonary tuberculosis and the proportion of extrapulmonary tuberculosis cases at a tertiary care centre in Aurangabad district of Maharashtra from the year 2010 to 2016. Methods: It is a retrospective study. Study duration was from 2010 to 2016. Patients were diagnosed as having tuberculosis with help of clinical examination, microbiological, radiological tests as per records and sputum was mentioned as positive or negative based on Ziehl Nelson staining for acid-fast bacilli. Records were analysed to describe the tuberculosis trends in terms of sputum-positive and sputum-negative pulmonary tuberculosis and the proportion of extra-pulmonary tuberculosis cases. Sites of extrapulmonary tuberculosis were described. Results: Total 6209 patients were analysed. Out of this, 3537 patients (56.97%) were having pulmonary TB and 2672 patients (43.03%) were having extrapulmonary TB. Pulmonary tuberculosis (3537 patients) was either sputum-positive (2435 patients, 68.84%) or sputum-negative (1102 patients, 31.16%) based on Ziehl -Nelson staining method. Extra pulmonary tuberculosis (2672 patients) was contributed by lymph node tuberculosis (766 patients, 28.67%), abdominal tuberculosis (570 patients, 21.33%), pleural effusion (687 patients, 25.71%), bone tuberculosis (139 patients, 5.20%), TB meningitis (248 patients, 9.28%), other rare sites of tuberculosis like breast, ophthalmological TB (262 patients, 9.81%). Conclusions: There was a high proportion of sputum-negative pulmonary TB as well as extrapulmonary TB cases.

Keywords: Extrapulmonary tuberculosis, sputum-negative pulmonary TB, Lymph Node TB.