TY - JOUR
T1 - Concomitant pulmonary disease is common among patients with extrapulmonary TB
AU - Shivakumar, S. V.B.Y.
AU - Padmapriyadarsini, C.
AU - Chavan, A.
AU - Paradkar, M.
AU - Shrinivasa, B. M.
AU - Gupte, A.
AU - Dhanasekaran, K.
AU - Thomas, B.
AU - Suryavanshi, N.
AU - Dolla, C. K.
AU - Selvaraju, S.
AU - Kinikar, A.
AU - Gaikwad, S.
AU - Kohli, R.
AU - Sivaramakrishnan, G. N.
AU - Pradhan, N.
AU - Hanna, L. E.
AU - Kulkarni, V.
AU - DeLuca, A.
AU - Cox, S. R.
AU - Murali, L.
AU - Thiruvengadam, K.
AU - Raskar, S.
AU - Ramachandran, G.
AU - Golub, J. E.
AU - Gupte, N.
AU - Mave, V.
AU - Swaminathan, S.
AU - Gupta, A.
AU - Bollinger, R. C.
N1 - Publisher Copyright:
© 2022 The Union.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - BACKGROUND: Microbiologic screening of extrapulmonary TB (EPTB) patients could inform recommendations for aerosol precautions and close contact prophylaxis. However, this is currently not routinely recommended in India. Therefore, we estimated the proportion of Indian patients with EPTB with microbiologic evidence of pulmonary TB (PTB). METHODS : We characterized baseline clinical, radiological and sputum microbiologic data of 885 adult and pediatric TB patients in Chennai and Pune, India, between March 2014 and November 2018. R E S U LT S : Of 277 patients with EPTB, enhanced screening led to the identification of 124 (45%) with concomitant PTB, including 53 (19%) who reported a cough .2 weeks; 158 (63%) had an abnormal CXR and 51 (19%) had a positive sputum for TB. Of 70 participants with a normal CXR and without any cough, 14 (20%) had a positive sputum for TB. Overall, the incremental yield of enhanced screening of patients with EPTB to identify concomitant PTB disease was 14% (95% CI 12-16). CONCLUS IONS : A high proportion of patients classified as EPTB in India have concomitant PTB. Our results support the need for improved symptom and CXR screening, and recommends routine sputum TB microbiology screening of all Indian patients with EPTB.
AB - BACKGROUND: Microbiologic screening of extrapulmonary TB (EPTB) patients could inform recommendations for aerosol precautions and close contact prophylaxis. However, this is currently not routinely recommended in India. Therefore, we estimated the proportion of Indian patients with EPTB with microbiologic evidence of pulmonary TB (PTB). METHODS : We characterized baseline clinical, radiological and sputum microbiologic data of 885 adult and pediatric TB patients in Chennai and Pune, India, between March 2014 and November 2018. R E S U LT S : Of 277 patients with EPTB, enhanced screening led to the identification of 124 (45%) with concomitant PTB, including 53 (19%) who reported a cough .2 weeks; 158 (63%) had an abnormal CXR and 51 (19%) had a positive sputum for TB. Of 70 participants with a normal CXR and without any cough, 14 (20%) had a positive sputum for TB. Overall, the incremental yield of enhanced screening of patients with EPTB to identify concomitant PTB disease was 14% (95% CI 12-16). CONCLUS IONS : A high proportion of patients classified as EPTB in India have concomitant PTB. Our results support the need for improved symptom and CXR screening, and recommends routine sputum TB microbiology screening of all Indian patients with EPTB.
KW - Mycobacterium tuberculosis infection
KW - cough
KW - infectious disease transmission
KW - retraining
KW - symptom evaluation
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U2 - 10.5588/ijtld.21.0501
DO - 10.5588/ijtld.21.0501
M3 - Article
C2 - 35351239
AN - SCOPUS:85127264972
SN - 1027-3719
VL - 26
SP - 341
EP - 347
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
IS - 4
ER -