Title : Frequency and associated factors of extra Pulmonary tuberculosis at a tertiary care hospital, Karachi, Pakistan
Abstract:
Introduction:
Tuberculosis (TB) is a communicable disease that is a major cause of illness and death worldwide. Risk factors for mortality in patients with Extra pulmonary tuberculosis (EPTB) include certain sites of disease other coexisting conditions, including HIV/AIDS; low socioeconomic status, and national origin. This study is designed to identify the frequency and factors associated with different types of EPTB. Preventive strategies can be made, and implementation can be done to reduce burden and overcome such a debilitating disease which is a major health care problem in Pakistan.
Methods:
This was a cross-sectional study conducted in the Internal Medicine Inpatient and Outpatient Department in the Indus Hospital Karachi from Sep 2022 to May 2023 with a total of 193 patients diagnosed with clinically or bacteriologically EPTB recruited in this study with informed consent. Patients were interviewed through a pre-designed questionnaire to obtain demographic information and end stage renal disease (ESRD) or 2 chronic kidney disease (CKD) or HIV. Performa had also included questions regarding risk factors of EPTB.
Results:
The total number of the patients included were 193 among them are 62.69% females & 37.31% males, 51.30% were married & 44.55% were single. The most prevalent comorbid was DM 9.8% followed by HTN 9.3%. 70.5% patients experienced weight loss & 64.8% patients was vaccinated for BCG & 35.2% were not. 55.4% patients had a history of TB contact and among them 79.4% had PTB contact & 20.6% EPTB. 81.3% patients was a new case & 18.7% had a history of TB. Among 18.7% patients who had TB 15% was PTB followed by 2.1% nodal. Most frequent sites of EPTB were reported to be pleural (30.1%) followed by abdominal (28%) and lymph nodes (24.4%) primarily. Almost 96% had reported first line drug therapy.
Conclusion:
Our study demonstrated that the common EPTB were tuberculous pleural followed by abdominal and lymph nodes. The clinicians should be alert to the presence of concurrent tuberculosis in EPTB, and all suspected cases of EPTB should be assessed for concomitant PTB to determine whether the case is infectious and to help for early diagnosis and treatment.
Key Words: Tuberculosis, Extra Pulmonary Tuberculosis, End Stage Renal Disease
