Prevalence of extrapulmonary tuberculosis and factors influencing successful treatment outcomes among notified cases in South India

Tuberculosis (TB) remains a significant public health issue globally, with extra pulmonary tuberculosis (epTB) accounting for a considerable number of TB cases. This study aims to improve our understanding of epTB epidemiology by evaluating treatment outcomes and identifying factors associated with positive and negative treatment results in epTB patients. A retrospective study was conducted from January 1, 2016, to December 31, 2019. EpTB and rifampicin-resistant epTB were identified using the GeneXpert MTB/RIF assay. Logistic regression analysis was performed to determine the associated risk factors. Among the 4,526 patients with extra pulmonary tuberculosis, the positivity rate of Mycobacteriuum tuberculosis among the epTB was 16.5%, and the rate of rifampicin-resistant epTB was 4.83%. Most of patients had lymphadenitis TB (n = 348, 38.79%), followed by those with pus (n = 241, 31.95%). Of 746 epTB cases, 679 patients (91.02%) achieved successful treatment outcomes. Of the 36 patients with rifampicin-resistant epTB, 30 (83.3%) exhibited successful treatment outcomes. Tuberculous peritonitis (OR: 1.58), aspirate (OR: 1.59), gastric lavage (OR: 1.45), biopsy (OR: 1.73), Tuberculosis meningitis (TBM) (OR: 1.46), and tissue samples (OR: 3.33) were all significantly associated with unfavourable treatment outcomes. Patients with extrapulmonary tuberculosis (epTB) aged between 35 and 44 had a significantly higher likelihood of experiencing unsuccessful outcomes (OR = 1.79; 95% CI: 0.74-4.31, p = 0.0912). Additionally, individuals with a history of alcohol use showed a higher likelihood of poor outcomes (OR = 1.90; 95% CI: 0.25-14.42). Moreover, tuberculosis patients who used tobacco also had an increased likelihood of unfavourable treatment outcomes (OR = 2.62; 95% CI: 0.35-19.68).The study indicated that the rate of favourable treatment outcomes among epTB patients surpassed the World Health Organization's target of ≥ 90%. However, a significant number of patients were lost to follow-up during treatment.