PREVALENCE OF EXTRAPULMONARY TUBERCULOSIS REACHING TERTIARY CARE CENTER

Background Extrapulmonary tuberculosis (EPTB) represents a major challenge to tuberculosis control because of its diverse clinical manifestations, diagnostic complexity, and delayed presentation. Although pulmonary tuberculosis is more common, extrapulmonary disease contributes substantially to morbidity and requires early recognition for optimal management. Limited institution-specific epidemiological data are available from tertiary care centres in South India. Methods A hospital-based descriptive cross-sectional study was conducted in the Department of Pulmonary Medicine, Sree Balaji Medical College and Hospital, Chennai, over a six-month period. Fifty consecutive adult patients diagnosed with extrapulmonary tuberculosis were enrolled. Demographic characteristics, anatomical site of disease, HIV status, diabetes mellitus, previous tuberculosis history, diagnostic delay, and treatment outcomes were recorded using a structured case record form. Univariate and multivariable logistic regression analyses were performed to identify predictors of diagnostic delay. Statistical analysis was performed using IBM SPSS Statistics version 26.0, with p<0.05 considered statistically significant. Results Among the 50 patients, the largest proportion belonged to the 31–45-year age group (36%), and males constituted 56% of the study population. Rural residents accounted for 62% of cases. Pleural tuberculosis (28%) was the most common site of extrapulmonary involvement, followed by lymph node tuberculosis (26%), abdominal tuberculosis (16%), central nervous system tuberculosis (12%), skeletal tuberculosis (10%), and genitourinary tuberculosis (8%). HIV infection and diabetes mellitus were present in 16% and 26% of patients, respectively, while 36% experienced a diagnostic delay exceeding eight weeks. Multivariable logistic regression identified rural residence (AOR 3.74; 95% CI: 1.02–13.74; p=0.047), HIV positivity (AOR 5.48; 95% CI: 1.03–29.03; p=0.046), and diabetes mellitus (AOR 3.21; 95% CI: 1.02–10.10; p=0.045) as independent predictors of diagnostic delay. Overall, 84% of patients demonstrated favourable treatment outcomes, whereas central nervous system tuberculosis showed the poorest response. Conclusion Pleural and lymph node tuberculosis were the predominant forms of extrapulmonary tuberculosis in this tertiary care centre. Rural residence, HIV infection, and diabetes mellitus were independently associated with delayed diagnosis. Early recognition of high-risk patients, wider availability of rapid molecular diagnostics, and integrated management of associated comorbidities may improve early diagnosis and treatment outcomes in extrapulmonary tuberculosis.