Abstract
BackgroundTuberculosis (TB) is one of the most common infectious diseases and is commonly associated with comorbidities. However, data regarding TB and comorbidities are lacking from northeast India. The aim of the study is to see the clinical spectrum of TB and the frequency of comorbidities.MethodsThis was a prospective observational study of all hospitalized TB patients between January 2016 and June 2017 who were selected by consecutive sampling. Data were analyzed using SPSS v. 17.0 (IBM Corp., Armonk, NY), and a p-value of <0.05 was considered significant.ResultsOf the 173 patients selected, the mean age was 41.05±17.04 years with a male:female ratio of 4.27:1. Pulmonary TB (PTB) was found in 43.94%, extra-pulmonary TB (EPTB) in 52.02%, and disseminated TB in 4.04%. Fever (61.27%) was the most common presentation, followed by cough (54.33%) and breathlessness (32.94%). Of the 76 patients with PTB and seven with disseminated TB, making a total of 83 patients, 56 (67.4%) were sputum positive. Out of 90 patients suffering from EPTB, pleural effusion (53.33%) was the commonest type of EPTB, followed by central nervous system (CNS) tuberculosis (26.66%) and abdominal tuberculosis (8.88%). Comorbidities were present in 53.17% of the patients, of which diabetes mellitus (DM) (26.58%) and hypertension (17.34%) were the most common. Comorbid conditions were significantly higher in PTB than EPTB (51 of 83 vs. 41 of 90, p<0.05). Mean glycated hemoglobin (HbA1c) was significantly higher in PTB as compared to EPTB (8.74±2.04 vs. 7.58±0.29, p<0.05).ConclusionComorbidities, particularly DM, were present in half of the patients, mostly in PTB than EPTB, with glycemic control being significantly poorer in PTB patients.
Highlights
India accounts for one-fourth of the global TB burden of tuberculosis (TB) in the world, with an estimated 2.8 million cases in 2015 [1]
Out of 90 patients suffering from extra-pulmonary tuberculosis (EPTB), pleural effusion (53.33%) was the commonest type of EPTB, followed by central nervous system (CNS) tuberculosis (26.66%) and abdominal tuberculosis (8.88%)
Comorbidities were present in 53.17% of the patients, of which diabetes mellitus (DM) (26.58%) and hypertension (17.34%) were the most common
Summary
India accounts for one-fourth of the global TB burden of tuberculosis (TB) in the world, with an estimated 2.8 million cases in 2015 [1]. Most countries with a high TB burden face a concomitant burden of associated medical comorbidities. These include liver diseases, chronic kidney diseases (CKD), diabetes mellitus (DM), cardiovascular diseases, connective tissue disorders, chronic obstructive pulmonary disease, and so on. Such medical comorbidities interact with TB at multiple levels. On one hand, these may aggravate the tubercular process from latent to active TB or even to disseminated forms, may cause diagnostic challenges, and lead to ineffective treatment. The aim of the study is to see the clinical spectrum of TB and the frequency of comorbidities
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