PREVALENCE OF TUBERCULOSIS IN KOTLI, AZAD KASHMIR
Abstract
Background: Tuberculosis is highly prevalent in Pakistan. It is a contagious disease and causes a lot of morbidity and mortality. Its treatment is costly especially for poor countries like Pakistan. But fortunately it is a preventable disease. Objective of this study was to analyse various epidemiological features of tuberculosis in District Kotli, a remote area of Northern Pakistan. Methods: This cross sectional study was conducted in District Kotli, Azad Kashmir from January to December 2009. Data was collected from eight national TB centres of District Kotli. It included all the diagnosed cases of tuberculosis, registered there during the study period. Various epidemiological aspects of these patients were analysed. Results: Total number patients registered during the study period were 752. Of these 579 (76.99%) were pulmonary and 173 (23%) were extra-pulmonary tuberculosis (EPT). Total prevalence of tuberculosis was found to be 100.27 per 100,000. Prevalence of pulmonary TB was 77.2 while that of EPT was 23.07 per 100,000. There were 405 males (53.85%) and 347 females (46.14%). Most patients were 61–75 years of age (220, 29.25%). Overall 417 (55.44%) were 46–75 years. Housewives were affected most frequently (324, 43.08%). Labourers were also commonly involved (40.82%). All cause mortality was 29 (3.85%). Mortality due to tuberculosis was 11 (1.04%). Among pulmonary tuberculosis, 259 (44.78%) were sputum smear positive and 320 (55.26%) were sputum smear negative. In EPT, most frequent was pleural effusion (74, 42%) and least frequent was skin involvement (3, 1.73%). Conclusion: Prevalence of tuberculosis in Kotli was lower than the overall prevalence in Pakistan. Male to female ratio was lower than that generally observed in Southeast Asia. It was more common in middle to old age population. Frequency was higher in housewives and labourers. Very significant proportion of pulmonary TB was sputum smear positive. Among EPT, pleural effusion was the most common mode of presentation.Keywords: Tuberculosis, Prevalence, Azad Kashmir, Extra-pulmonary tuberculosis, Mortality, PakistanReferences
World Health Organization. Global Tuberculosis Report 2012.
Connell DW, Berry M, Cooke G, Kon OM. Update on tuberculosis: TB in the early 21st century. Eur Respir Rev 2011;20(120):71–84.
Raviglione MC, O’Brien RJ. Tuberculosis. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al, (Eds). Harrison’s Principles of Internal Medicine. (17th ed). New York: MacGraw-Hill; 2008.p. 1006–20.
Metzger P, Baloch NA, Kazi GN, Bile KM. Tuberculosis control in Pakistan: reviewing a decade of success and challenges.
World Health Organization. Global tuberculosis control. WHO report 2011. WHO/HTM/TB/2011.16.
Khurram M, Khaar HTB, Fahim M. Multi-drug-resistant tuberculosis in Rawalpindi, Pakistan. J Infect Dev Ctries 2012;6(1):29–32.
Dogar OF, Shah SK, Chughtai AA, Qadeer E. Gender disparity in tuberculosis cases in eastern and western provinces of Pakistan. BMC Infect Dis 2012;12:244.
Hudelson P: Gender differentials in tuberculosis: the role of socioeconomic and cultural factors. Tuberc Lung Dis 1996;77:391–400.
Chocano-Bedoya P, Ronnenberg AG. Vitamin D and tuberculosis. Nutr Rev 2009;67:289–93.
Ustianowski A, Shaffer R, Collin S, Wilkinson RJ, Davidson RN. Prevalence and associations of vitamin D deficiency in foreign-born persons with tuberculosis in London. J Infect 2005;50:432–7.
Connolly M, Nunn P. Women and tuberculosis. Tuberculosis research and surveillance unit, World Health Organization, Geneva. World Health Stat Q 1996;49:115–9.
Kolappan C, Subramani R. Association between biomass fuel and pulmonary tuberculosis: a nested case-control study. Thorax 2009;64:705–8.
Yip L, McCluskey J, Sinclair R: Immunological aspects of pregnancy. Clin Dermatol 2006;24:84–7.
Ihsanullah, Muhammad A, Khan N, Zaman M. Frequency of sputum positive AFB cases among patients of pulmonary tuberculosis in tertiary care hospitals of northern Pakistan. J Ayub Med Coll Abbottabad 2010;22(2):56–60.
Global tuberculosis control –epidemiology, strategy, financing. WHO report 2009. Geneva, World Health Organization, 2009 (WHO/HTM/TB/2009.411).
Korzeniewska-Koseła M. [Tuberculosis in Poland in 2010]. Przegl Epidemiol 2012;66(2):329–34. [Article in Polish]
Golden MP, Vikram HR. Extra pulmonary tuberculosis: an overview. Am Fam Physician 2005;72(9):1761–8.
Zenebe Y, Anagaw B, Tesfay W, Debebe T, Gelaw B. Smear positive extra pulmonary tuberculosis disease at University of Gondar Hospital, Northwest Ethiopia. BMC Res Notes 2013;6:21.
World Health Organization. Treatment of tuberculosis: Guidelines. 4th. WHO/HTM/TB/2009.420.
W LR. Update on tuberculous pleural effusion. Respirology 2010;15(3):451–8.
Fanning A. Tuberculosis: 6. Extrapulmonary disease. CMAJ 1999;160(11):1597–603.
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