Extrapulmonary tuberculosis in Pakistan- A nation-wide multicenter retrospective study

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Pakistan faces a high burden of tuberculosis (TB), with a notable rise in extrapulmonary tuberculosis (EPTB).
• EPTB constitutes 20% of all notified TB cases, yet epidemiological data remains limited.
• Understanding EPTB demographics, clinical features, and outcomes is crucial for public health strategies.

Purpose of the Study:

• To describe the demographic characteristics of EPTB patients in Pakistan.
• To elucidate the clinical manifestations of EPTB across different regions and age groups.
• To evaluate the treatment outcomes for various forms of EPTB.

Main Methods:

• Descriptive analysis of routinely collected national TB data from 2016.
• Inclusion of data from 50 study sites selected via stratified convenient sampling.
• Analysis of 15,790 EPTB cases among 54,092 total TB registrations.

Main Results:

• EPTB was more prevalent in females (30.5%) and children (2.0 times higher likelihood).
• Pleural (29.6%), lymphatic (22.7%), and abdominal TB (21.0%) were the most common forms.
• Treatment success rates for EPTB were generally high, with exceptions for CNS TB.

Conclusions:

• The study offers insights into EPTB demography, clinical presentations, and treatment outcomes in Pakistan.
• Significant variations in EPTB epidemiology and clinical manifestations exist between provinces.
• Further research is recommended to address provincial disparities, identify risk factors, and improve EPTB management.