BURDEN OF EXTRA PULMONARY TUBERCULOSIS (EPTB) AMONG PATIENTS ATTENDING A TERTIARY CARE MEDICAL COLLEGE OF EASTERN INDIA

Tuberculosis (TB) remains a major global health threat, ranking as the seventh leading cause of death. While pulmonary TB has seen some control, Extrapulmonary tuberculosis (EPTB), which affects organs outside the lungs, presents significant diagnostic and management challenges, especially in resource-limited regions. This study focuses on the prevalence, diagnostic methods, and epidemiology of EPTB at a tertiary care medical college in Eastern India. Conducted from January 2023 to June 2024, the study included consecutive EPTB samples such as pleural fluid, lymph node aspirates, biopsy tissues, urine, and semen. Samples were processed using Ziehl-Neelsen (ZN) and fluorescent staining, with Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) used for Mycobacterium tuberculosis detection. Of the 528 samples analyzed, 58.14% were male, and the majority (25.37%) were in the 16-29 age group. Lymph nodes (27.46%) and pus aspirates (24.24%) were the most common sites of infection. Smear microscopy and fluorescent staining revealed a 5.68% positivity rate, while CBNAAT showed a higher 10.41% positivity, with 53% of smear-negative samples testing positive. One case of multidrug-resistant (MDR) EPTB was identified. The study underscores the diagnostic challenges posed by the paucibacillary nature of EPTB and the limitations of current techniques, particularly in underresourced settings. The findings highlight the need for improved diagnostic protocols, including the establishment of culture and drug susceptibility testing (CDST) facilities, better sample referral practices, and more comprehensive training for healthcare workers. Early and accurate diagnosis, along with timely treatment, are critical for reducing the burden of EPTB and preventing drug resistance in high-burden areas like West Bengal.