A Retrospective Analysis of Pulmonary and Extra-Pulmonary Tuberculosis Drug Resistance in Punjab, Pakistan

17 Pages Posted: 18 Jul 2024

See all articles by Zomer Sardar

Zomer Sardar

affiliation not provided to SSRN

Carla Y. Kim

Cornell University - Department of Neurology

Jackson Roberts

affiliation not provided to SSRN

Safia Bano

affiliation not provided to SSRN

Kiran T. Thakur

Department of Neurology - Columbia University Irving Medical Center

Abstract

BackgroundThis study aims to investigate drug resistance patterns in pulmonary and extra-pulmonary tuberculosis (TB), including central nervous system (CNS)-TB, using the largest reference laboratory in Punjab, Pakistan.MethodsRetrospective data from 2012 to 2022 were collected from 1410 patients referred to the multidrug resistant (MDR)-TB laboratory of Mayo Hospital, Lahore, Pakistan. The drug resistant (DR) testing was performed on sputum or pleural fluid in patients with pulmonary tuberculosis, and on cerebrospinal fluid in patients with CNS-TB.ResultsThe mean age was 35±15.9 years, with a higher proportion of females (50.5%; 712). Of the cases, 96.5%; 1361 presented with pulmonary TB, while 4% (56) had isolated extra-pulmonary TB. Among the extra-pulmonary cases, 1.3% (18) had CNS-TB. A significant percentage (67.8%; 956) exhibited MDR-TB, with 25.3% (356) showing rifampicin resistance. Moreover, 6% (85) demonstrated resistance to both first and second-line drugs, with 0.4% (5) resistant to all first-line anti-TB drugs. Of the CNS-TB cases, 56% (10) had confirmed rifampicin resistance. Most patients (81.9%; 1152) had previously received first-line anti-TB drugs.ConclusionThis study underscores the high burden of DR-TB in endemic regions, and the need for further large-scale investigations to better understand resistance patterns and inform effective management strategies.

Note:
Funding declaration: none

Conflict of Interests: none

Ethics statement: This study was approved by the institution and ethical review board of King Edward Medical University, Mayo Hospital.

Keywords: drug resistance tuberculosis, multidrug resistance, extra-pulmonary tuberculosis

Suggested Citation

Sardar, Zomer and Y. Kim, Carla and Roberts, Jackson and Bano, Safia and Thakur, Kiran T., A Retrospective Analysis of Pulmonary and Extra-Pulmonary Tuberculosis Drug Resistance in Punjab, Pakistan. Available at SSRN: https://ssrn.com/abstract=4887328 or http://dx.doi.org/10.2139/ssrn.4887328

Zomer Sardar

affiliation not provided to SSRN ( email )

No Address Available

Carla Y. Kim (Contact Author)

Cornell University - Department of Neurology ( email )

New York, NY
United States

Jackson Roberts

affiliation not provided to SSRN

Safia Bano

affiliation not provided to SSRN ( email )

No Address Available

Kiran T. Thakur

Department of Neurology - Columbia University Irving Medical Center ( email )

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