537. Burden of Tuberculosis in a Private Indian Setting: An Experience
Session: Poster Abstract Session: Tuberculosis Epidemiology and Diagnosis
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDweek_poster_Suneetha_Narreddy.pdf (470.2 kB)
  • Background:

    Notification of Tuberculosis (TB) cases from the private sector to state public health officials is a challenge. This helps to better practices in terms of Standard TB Care which include helping the patients to get right diagnosis, treatment, Follow up & facilitates social support systems. From 2009-2014, only 8.4% of total TB cases from the private sector were notified, with a majority being unaccounted for in the country. Multidrug resistant (MDR) TB is a major challenge which needs to be addressed by all the stake holders.

    The goal was to assess the burden of TB in private sector, determine the site of disease and estimate drug resistance.

    Methods:

    A single centre prospective study was conducted in a tertiary care hospital. Patients over 18years diagnosed with TB from July 2015 to May 2016 were included. Transplant patients and those with hematologic malignancies were excluded. Demographics, diagnostic tests, drug resistance patterns were recorded and analyzed.

    Results:

    Two hundred and fifty six (mean age 18-45years) cases were studied.
    GENDER
    Male 150 (58.59%)
    Female

    106 (41.41%)

    AGE
    18-30yrs 84 (32.81%)

    31-45yrs

    69 (26.95%)
    46-60yrs

    62 (24.6%)

    >60yrs 40 (15.62%)
    PREVIOUS HISTORY OF TB
    1st episode 232 (93.6%)
    Recurrence 24 (9.37%)
    RISK FACTORS
    Diabetes mellitus 31 (12.1%)
    Malnutrition 21 (8.2%)
    HIV 15 (5.85%)
    Steroids 15 (5.85%)
    Others 3 (1.17%)
    DIAGNOSIS

    Ziehl Neelsen stain

    Bactec acid fast bacilli culture
    Xpert NAAT
    Radiology + Pathology 104
    Clinical 7
    SITE OF DISEASE
    Pulmonary 30.8%
    Lymph node 27.73%
    Spine 11.71%
    CNS 10.93%
    Disseminated  7.03%
    Abdomen 5.85%
    Bone 1.95%
    Others 3.9%
    DRUG RESISTANCE
    Isoniazid + Rifampicin + Ethambutol 10 (66.6%)
    Rifampicin  3 (20%)
    Isoniazid + Rifampicin 1 (6.6%)
    Isoniazid + Para amino salicylic acid 1 (6.6%)

    MDR TB (n=15)

    Lung 5
    Lymph node 4
    Spine 2
    Central nervous system 1
    Bone 1
    Others 2

    Conclusion:

    Tuberculosis burden in India is increasing inspite of lot of efforts made to contain it. Diabetes mellitus is one of the risk factors for TB. Extra pulmonary TB was more commonly encountered. Gene Xpert testing is being increasingly used. Drug resistant TB was observed at 5.85%. Isoniazid resistance may be under reported as Isoniazid testing is not routinely performed. Clinicians in the private setting need to improve the reporting of TB.

    Suneetha Narreddy, MD1, Aparna Yerramilli, M Pharm, Pharm D2, Sneha Amulya Allam, Pharm D candidate3, Sai Priya Sesha, Pharm D candidate3, Sarika Kumari Boinapalli, Pharm D candidate3, Archana Trivedi, MBBS4, Ratna Rao, MD1, Ratnamani Sharma, MD1, Asra Farheen, Social Worker4 and Sarabjit Chadha, MD4, (1)Apollo Hospital, Hyderabad, India, (2)Pharmacy Practice, Sri Venkateshwara College of Pharmacy, affiliated to Osmania University, Hyderabad, India, (3)Sri Venkateshwara College of Pharmacy, Hyderabad, India, (4)International Union Against Tuberculosis and Lung Diseases, New Delhi, India

    Disclosures:

    S. Narreddy, None

    A. Yerramilli, None

    S. A. Allam, None

    S. P. Sesha, None

    S. K. Boinapalli, None

    A. Trivedi, None

    R. Rao, None

    R. Sharma, None

    A. Farheen, None

    S. Chadha, None

    Previous Abstract | Next Abstract >>

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.