LAUSR

Background: Tuberculosis (TB) is one of the major public health problems in Pakistan. Pakistan ranks fifth amongst TB high-burden countries worldwide. Diagnosis and management of TB remains challenging and complex because of the heterogeneity of disease presentation. Objective: To evaluate the outcomes of pulmonary and extra pulmonary tuberculosis treated at a tertiary care center of a high TB burden country. Methods: An observational study on patients treated for TB at outpatient pulmonology clinics of Aga Khan University hospital, Pakistan from July 2014 to July 2016. The patients receiving treatment were followed and the outcomes were analyzed. Results: Total of 244 patients were treated, 166(63.9%) patients were treated as pulmonary TB (PTB) and 75(30.7%) were treated as extra pulmonary TB (EPTB) and 13(5.3%) patients were treated as both. AFB culture was positive in 91(37.2%) patients. 200 (82%) patients were completely cured after treatment with 33(13.5%) as lost to follow up, 7 (2.9%) as treatment failure and 4 (1.6 %) died. The pattern of drug resistance in out of the 91 AFB culture positive samples were; 76 (83.51%) pansensitive to all first line drugs, 6 (6.59%) were MDR TB, 3(3.29%) XDR TB, 3(3.29%) pre-XDR and 3(3.29%) showed mono drug resistance. Conclusion: The cure rate of PTB and EPTB in our cohort of patient was satisfactory but the high lost to follow up patients are the major concern and require an intense case follow up strategies. Moreover the drug resistance specially the growing XDR and pre XDR are alarming and need early diagnosis and management.