Abstract

Background: Tuberculosis (TB) causes 1.8 million deaths per year globally. TB is now a global priority for research and development. India accounts for >1/4th of global TB burden - 27 lakh out of 1 Crore new cases annually. Many patients with extrapulmonary TB (EPTB) can have pulmonary involvement who can be potentially infectious.

Aims and Objectives: This study was undertaken to measure TB positivity and their rifampicin resistance rates in different clinical samples. Sputum TB positivity in EPTB patients was also detected.

Materials and Methods: Different samples of clinically suspected patients accounting for 1427 patients for 3 months were tested for TB positivity and Rifampicin resistance by Truenat MTB/RIF assay in R. G. Kar MCH. Biopsy, bones, and tissues were excluded due to lack of facility. Their demographic profile and risk factors were recorded.

Results: TB positivity and rifampicin resistance rates in positive samples respectively – sputum (19.01%, 7.86%), pleural fluid (10.78%, 9.11%), bronchoalveolar lavage fluid (4%, 0%), DTA (0%, 0%), gastric lavage (5.26%, 0%), L.N. fine needle aspiration cytology (6.25%, 0%), ascitic fluid (2.13%, 0%), cerebrospinal fluid (5.17%, 0%), urine (2.13%, 0%), and synovial fluid (50%, 0%). Rifampicin resistance was more common among pulmonary samples. Patients with pleural TB had the highest associated sputum TB positivity. Important risk factors were smoking, diabetes, HIV infection, and post-COVID. Overall, the most common age group affected: 21–40 years (38%) including males (64.8%) and females (35.2%).

Conclusion: Truenat, sensitive and specific testing with low turnaround time in resource-poor settings is excellent for early diagnosis and prompt treatment of both pulmonary and EPTB. Overall, pulmonary TB had greater rifampicin resistance rates. Smoking, diabetes, HIV infection, and post-COVID infection were associated risk factors.

Key words: Tuberculosis; TruenatMTB/RIFassay; Extrapulmonary Tuberculosis; Rifampicin Resistance