Tuberculosis: an experience at government chest disease hospital

Background: This retrospective study was carried out to find the incidence, clinical profiles and treatment outcome of pulmonary and extrapulmonary tuberculosis patients attending the only Chest Disease Hospital in Srinagar.Methods: A retrospective analysis of 613 patients having EPTB and PTB was undertaken from the chest disease hospital of Government Medical College Srinagar. Demographic characteristics, clinical features and treatment outcome were obtained from medical case records of all patients visiting the hospital for a period of two years from May 2016-May 2018.Results: The study comprised of 613 patients, out of which 365% were having pulmonary TB while 35% were having extrapulmonary TB. Majority of patients (44.5%) in TB group were in age group 10-30 while majority of patients (42%) in EPTB group were in age group 51-70. Males were seen more commonly affected. Majority (90%) of patients in EPTB group had pleural effusion. Majority of patients (71%) were smear positive by ZN staining in PTB group. Majority (90%) of PTB patients in smear negative group were BAL negative. In PTB group 8% were treatment failure while in EPTB group 2% were treatment failure. MDR was seen in 4.2% of total tuberculosis patient while XDR was seen in 0.32% of total patients. Out of treatment failure in PTB group MDR was seen in 64% followed by monoresistance to INH in 30% and XDR in 6%. In EPTB group MDR was seen in 100% of treatment failure. All patients with XDR died. Among the MDR patients majority are on treatment while 12% died, another 12% defaulter while 12% completed treatment.Conclusions: Among evaluated tuberculosis patients, maximum had PTB. Pleural tuberculosis was the most common presentation of EPTB. The study shows male preponderance in both groups. Treatment response was excellent with failure rate of 8% in PTB and 2% in EPTB. Most common cause of failure was MDR. XDR was seen in two patients and both of them died