Abstract

BackgroundThere is limited published data form Pakistan on treatment success rate among extrapulmonary tuberculosis (EPTB) patients. The aim of this study was to assess clinical form, treatment outcomes, and identify the factors associated with unfavorable treatment outcome among EPTB patients.MethodsA retrospective study was conducted at the Chest Disease Unit of the Bahawal Victoria Hospital, Pakistan. Medical records of EPTB patients, registered at the study site from January 1, 2015 to September 30, 2017, were reviewed to obtain the data. Final treatment outcomes among EPTB patients were evaluated in accordance with the standard Word Health Organization (WHO) criteria. Multivariate binary logistic regression analysis was used to identify the factors associated with unfavorable treatment outcome.ResultsA total of 651 EPTB patients were included in the study. Highest proportion of patients had pleural TB (n = 217, 33.3%). Out of the total 651 patients, 463 (71.1%) successfully completed the treatment. Among 177 (27.2%) patients with unfavorable treatment outcome, 10 (1.5%) died, while 165 (25.4%) lost to follow-up the treatment. Lymph node TB (AOR 0.65, 95% CI 0.422, 0.989) and meningeal TB (AOR 2.1, 95% CI 1.065, 4.144) were significantly associated with unfavorable treatment outcome.ConclusionThe treatment success (favorable outcome) rate among EPTB patients was less than the target (i.e., ≥ 90%) set by the WHO. Highest proportion of patients lost to follow-up during the treatment.

Highlights

  • Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis

  • The aim of this study was to assess clinical form, treatment outcomes and identify the factors associated with unfavorable treatment outcome among extrapulmonary tuberculosis (EPTB) patients at the Bahawal Victoria Hospital (BVH), Punjab, Pakistan

  • During the study period, a total of 723 EPTB patients were registered at the study site

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Summary

Introduction

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis It is primarily a disease of the lungs (i.e., pulmonary TB), but can affect other organs of the body (i.e., extrapulmonary TB) [1]. The International Union against Tuberculosis and Lung Disease and the World Health Organization (WHO) jointly published recommendations to standardize the reporting of treatment outcomes among TB patients. Though, these recommendations are aimed at pulmonary tuberculosis (PTB) but are used for EPTB [7]. Gender, type of patient, Human Immunodeficiency Virus (HIV) status and diabetes as most common factors associated with treatment success rate among EPTB patients [7, 11]. The aim of this study was to assess clinical form, treatment outcomes, and identify the factors associated with unfavorable treatment outcome among EPTB patients

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