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TRENDS OF EXTRA-PULMONARY TUBERCULOSIS UNDER REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME: A STUDY FROM SOUTH DELHI*

Extra-pulmonary tuberculosis (EPTB) is a milder form of disease in terms of infectivity as compared to pulmonary TB (PTB). Whereas sputum can be easily obtained for the detection of disease in lungs, diagnosis of EPTB is often difficult requiring invasive and expensive serological/radiological investigations. A category-wise drug treatment is similar for the two forms of disease1. However, an assessment of end point of cure is a problem with EPTB. With the global rise of human immunodeficiency viral (HIV) infection over last decade, studies have reported increasing association of EPTB in HIV infected individuals2,3. Prevalence of EPTB has also been found to be high in paediatric TB cases4. In the past, treatment of EPTB has. | Original Article TRENDS OF EXTRA-PULMONARY TUBERCULOSIS UNDER REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME A STUDY FROM SOUTH DELHI V. K. Arora 1 and Rajnish Gupta2 Original received on 6.5.2005 Revised version received on 4.8.2005 Accepted on 16.8.2005 Summary Background Objectives Extra-pulmonary tuberculosis EPTB cases have been treated with a daily short course chemotherapy SCC regimens in past. Following the success of Directly Observed Treatment-Short Course DOTS programme over recent years a study was carried out to determine prevalence of EPTB to draw comparison between annual case detection of pulmonary TB PTB and extra-pulmonary TB and to assess outcome of DOTS in EPTB in a patient population of Delhi. Methods All consecutive EPTB cases of Delhi diagnosed within LRS Institute of TB and Respiratory Diseases between January 1996 to March 2003 and subsequently given DOTS at the area DOTS Centres constituted the study group. Results Of overall 14185 cases 2849 20 had EPTB. A significantly higher prevalence was observed in females 57 and in young age mean standard deviation of 23.4 12.8 years . Commonest involved site was lymph node 54 . Whereas number of PTB and EPTB cases have increased over successive years percentage of former declined significantly through 84 in 1996 to 78 in 2002 and that of latter rose significantly through 16 to 22 correspondingly. EPTB to PTB ratio changed significantly from 1 5 at start to about 1 3.5 at study-conclusion. Treatment completion was observed in 94 1775 1885 of EPTB cases. Conclusions Under Revised National TB Control Programme RNTCP employing a DOTS strategy annual case detection has improved for both pulmonary and extra-pulmonary TB. Cure of infectious disease is likely to have resulted in a relative rise of the annual EPTB case detection. DOTS effected an acceptable treatment outcome in EPTB case management. Indian J Tuberc 2006 53 77-83 Key words Tuberculosis TB Extra-pulmonary tuberculosis EPTB Directly Observed