Publication:

Presumptive pulmonary tuberculosis and its associated factors among adult patients availing out-patient services in a tertiary care center, Puducherry, South India

Background In line with WHO’s END TB strategy and Sustainable Development Goal’s vision, India has set a goal to eliminate tuberculosis by 2025. To meet this goal, intensified case finding is a strategy adopted by India’s national tuberculosis program. This study aimed to determine the proportion of presumptive pulmonary tuberculosis (PPTB) patients among outpatients of a tertiary care center and its association with socio-demographic and behavioral factors.

Methods A hospital based cross-sectional analytical study was done in a tertiary care center during November 2017 among outpatients aged 18 years or above. Known cases of tuberculosis (TB) were excluded. Information on socio-demographic characteristics and TB symptoms was collected using a structured questionnaire. A person with any symptom suggestive of TB, including, cough of any duration, subjective weight loss, and fever at present was considered to have PPTB. Presence of PPTB was reported as proportion with 95% confidence intervals. Association between variables and presumptive pulmonary TB was assessed using chi square test and prevalence ratio with 95% CI.

Results Among 2638 outpatients, 907 (34%) had PPTB. Cough was the most reported symptom (22.9%); followed by fever (10.0%), weight loss (13.9%) and hemoptysis (0.9%). PPTB was found to be significantly higher among males, smokers, alcohol users and patients having a history of contact with any TB patient.

Conclusions One-third of the outpatients had PPTB and this was high. A screening procedure could be incorporated within the hospital policy to identify outpatients with symptoms of TB.