A prospective study on the clinical profile, risk factors, diagnosis and management of pulmonary and extrapulmonary tuberculosis at a tertiary care hospital in Nagapattinam, India

Background: Tuberculosis (TB) remains a major global public health challenge, presenting primarily as pulmonary TB (PTB) or, less commonly, as extra pulmonary TB (EPTB).

Objectives: This study aimed to: (1) document the clinical symptoms of PTB and EPTB; (2) identify associated risk factors; (3) classify the types of EPTB observed; (4) evaluate diagnostic approaches; and (5) review treatment regimens for drug-sensitive TB, multi drug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB).

Methods: A prospective observational study was conducted from April to September 2024 at Government Medical College Hospital, Nagapattinam, involving 250 confirmed TB patients. Demographic, clinical, diagnostic, and treatment data were collected and analysed.

Results: PTB accounted for 83.6% of cases, while EPTB represented 16.4%. Male patients predominated (63.6%), and the highest prevalence occurred among adults aged 19–59 years (54%). The most common PTB symptoms included cold-like manifestations (90.9%), weight loss (85.1%), and cough (74.6%). Lymph nodes (26.8%), pleura (21.9%), and genital sites (17%) were the most frequently affected EPTB locations. Notable risk factors included smoking (15%), alcohol use (12%), HIV infection (10%), and diabetes mellitus (8%). Diagnosis was established using sputum smear microscopy, culture, radiographic imaging, and site-specific tests. All patients were treated according to WHO-recommended regimens, with modifications for MDR-TB.

Conclusion: Pulmonary TB remains the predominant form, with lymph node, genital, and pleural TB as the leading extra pulmonary sites. The findings underscore the influence of behavioural and chronic disease risk factors and highlight the need for integrated TB control strategies. Strengthening early diagnosis and adherence to WHO-recommended treatment is critical to achieving India’s TB elimination target by 2025.