Study of clinical profile of childhood extra pulmonary tuberculosis

Background: The objectives were to describe the demographic and clinical profile and treatment outcomes in the National Tuberculosis Program Center of Duhok governorate. Methods: This was a descriptive retrospective study of all forms of drug-susceptible tuberculosis cases in the National Tuberculosis Program Center of Duhok. The Electronic Nominal Recording Reporting System data of tuberculosis cases were reviewed during 2014–2018. Information on the demographic, clinical, and laboratory characteristics of the patients were analyzed. Tuberculosis trends and treatment outcomes were determined. Results: A total of 1063 tuberculosis patients visited the National Tuberculosis Program Center, of whom 905 were from Duhok. The estimated tuberculosis notification rate per 100,000 people in Duhok governorate was 14.06, 16.16, 10.43, 11.05, and 10.34 for the years 2014, 2015, 2016, 2017, and 2018, respectively. The most affected age group was 15–24 years. The male cases were predominant. Most patients (97.3%) were native Iraqi. There were 718 (67.5%) pulmonary tuberculosis cases and 345 (32.5%) extra-pulmonary tuberculosis cases; tuberculosis lymphadenitis was the most common presentation. The majority of extra-pulmonary tuberculosis patients were females aged 15–24 years (p = 0.019), and patients aged ⩾65 years were associated with pulmonary tuberculosis and extra-pulmonary tuberculosis in males (p ⩽ 0.001). The highest tuberculosis incidence occurred in winter (288 patients). The patient treatment outcomes were as follows: 90.7% successful treatment, 1.6% lost to follow-up, 6.7% death, 0.3 transferred out, and 0.8 treatment failure. Conclusion: There was a high frequency of extra-pulmonary tuberculosis, which may reflect overestimation in its diagnosis. Therefore, meticulous evaluations should be provided. The treatment outcome was satisfactory in the center. Hence, we should maintain the favorable work to attain tuberculosis control objectives. Performing GeneXpert for all tuberculosis cases and introducing culture and drug susceptibility testing should be an urgent plan to strengthen the diagnosis of susceptible and drug-resistant tuberculosis cases.

Download Full-text

Clinical profile of 128 HIV positive cases with abdominal tuberculosis

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20160089 ◽

2016 ◽

Vol 2 (1) ◽

pp. 18 ◽

Cited By ~ 2

Author(s):

Mangala S. Borkar ◽

Anil Shrinivasrao Joshi ◽

Akshay Arvind Kashid ◽

Chaya Ganpat Gawale ◽

Rohit Dharmaraj Kakade ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Abdominal Tuberculosis ◽

Clinical Profile ◽

Hiv Positive ◽

Chronic Diarrhoea ◽

Extra Pulmonary Tuberculosis ◽

Presenting Symptoms ◽

The Common ◽

Extra Pulmonary ◽

Loss Of Appetite

Background: Tuberculosis and HIV co-infection remains a major public health challenge throughout the world. An extra 25% of deaths among TB patients are attributable to co-infection with HIV according to the WHO 2009 TB report. TB is often the first opportunistic infection and a leading cause of death in HIV infected persons. The main objective was to study the clinical profile of the patients co-infected with HIV and abdominal tuberculosis in Government Medical College, Aurangabad.Methods: Patients co-infected with HIV and abdominal tuberculosis were included in this observational study. Patients were either HIV positive and later diagnosed to have abdominal tuberculosis or diagnosed to be HIV positive when investigations were done after the diagnosis of abdominal TB. The common presenting symptoms were weight loss, fever, loss of appetite, pain in the abdomen and chronic diarrhoea. Ultrasound and routine chest X-ray were done along with other routine blood investigations including CD4 count.Results: We studied 407 cases of HIV-TB co-infected patients out of whom 248 (61%) were of extra-pulmonary tuberculosis. Out of 248, 128 cases (51.6%) were diagnosed to have abdominal tuberculosis which was the commonest type of extra pulmonary tuberculosis in HIV –TB co- infected patients. They had higher morbidity, but we found that 96.06% patients completed anti-tubercular treatment and responded. Mortality rate of abdominal TB was lowest (3.94%) among all types of extra-pulmonary and also pulmonary TB in HIV co -infected patients. So we can conclude that HIV TB co infected patients show good response to anti- tubercular treatment if we diagnose this condition early.Conclusions: Abdominal tuberculosis is the commonest type of extra pulmonary tuberculosis in HIV patients. On ultrasonography, the common abnormalities seen were intra-abdominal lymphadenopathy, splenic abscesses, ascites etc. All the patients who were diagnosed within few weeks of symptoms recovered with anti tubercular therapy, similar to HIV negative patients.

Download Full-text