Next Article in Journal
A Rapid Assessment of Health Literacy and Health Status of Rohingya Refugees Living in Cox’s Bazar, Bangladesh Following the August 2017 Exodus from Myanmar: A Cross-Sectional Study
Previous Article in Journal
A Serological Survey of Selected Papua New Guinea Blood Donors for Hepatitis B and Related Co-Infections
Previous Article in Special Issue
Combined Tuberculosis and Diabetes Mellitus Screening and Assessment of Glycaemic Control among Household Contacts of Tuberculosis Patients in Yangon, Myanmar
Open AccessArticle

Does Drug-Resistant Extrapulmonary Tuberculosis Hinder TB Elimination Plans? A Case from Delhi, India

1
Lok Nayak Hospital, New Delhi 110002, India
2
All India Institute of Medical Sciences, Nagpur 441108, India
3
International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi 110016, India
4
All India Institute of Medical Sciences, New Delhi 110029, India
5
Rajan Babu Institute of Pulmonary Medicine and Tuberculosis, New Delhi 110009 India
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2020, 5(3), 109; https://doi.org/10.3390/tropicalmed5030109
Received: 11 March 2020 / Revised: 27 May 2020 / Accepted: 28 May 2020 / Published: 1 July 2020
Extrapulmonary drug-resistant tuberculosis (DR-EPTB) poses a formidable diagnostic and therapeutic challenge.Besides associated with high morbidity, it is a major financial burden for the patient and the health system. In spite of this, it has often been neglected as it does not “pose” a visible public health threat. We study clinical profiles, treatment outcomes, and factors associated with unfavourable outcomes among DR-EPTB patients under programmatic settings in New Delhi, India, and evaluate how this could impact TB elimination. A retrospective analysis of all DR-EPTB patients registered at three nodal DR-TB centres in Delhi in 2016 was carried out. Of the 1261 DR-TB patients registered, 203 (16%) were DR-EPTB, with lymph nodes (118, 58%) being the most common site, followed by bone (69, 34%). Nearly 29% (n = 58) experienced adverse drug reactions with severe vomiting (26, 13 %), joint pain (21, 10%) and behavioral disorder (15, 7%). History of previous TB treatment was observed in a majority of the cases (87.7%). Nearly one-third of DR-EPTB cases (33%) had unfavourable treatment outcomes, with loss-to-follow-up (n = 40, 58%) or death (n = 14, 20%) being the most common unfavourable outcomes. In the adjusted analysis, weight band 31–50 kilograms (aRR = 1.8, 1.2–3.4) and h/o previous TB (aRR = 2.1, 1.1–4.8) were mainly associated with unfavourable outcomes. TB elimination efforts need to focus on all forms of TB, including DR-EPTB, leaving no one behind, in order to realise the dream of ending TB. View Full-Text
Keywords: adverse drug reactions; unfavourable outcome; lymph node TB; bone TB; TB elimination; extrapulmonary tuberculosis adverse drug reactions; unfavourable outcome; lymph node TB; bone TB; TB elimination; extrapulmonary tuberculosis
Show Figures

Figure 1

MDPI and ACS Style

Lohiya, S.; Tripathy, J.P.; Sagili, K.; Khanna, V.; Kumar, R.; Ojha, A.; Bhatnagar, A.; Khanna, A. Does Drug-Resistant Extrapulmonary Tuberculosis Hinder TB Elimination Plans? A Case from Delhi, India. Trop. Med. Infect. Dis. 2020, 5, 109.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop