Awareness regarding Eptb

Extrapulmonary tuberculosis (EPTB) is a significant public health problem that poses diagnostic dilemma. The changing epidemiology of tuberculosis (TB) due to acquired immunodeficiency syndrome (AIDS) has brought extra pulmonary tuberculosis (EPTB) into focus. The diagnosis of EPTB is challenging and more so when it involves deeply located inaccessible area. The protean non-specific presentations, paucibacillary nature, difficulty in procuring appropriate and adequate sample, lack of awareness among clinicians, and poor performance of conventional microbiological techniques in EPTB are all contributory to challenges in diagnosis of EPTB leading to delayed diagnosis, missed diagnosis and over diagnosis and hence increased mortality. EPTB constitutes 15 to 20% of all case of tuberculosis in immune competent patients and for more than 50% of cases in Human Immunodefeciency Virus (HIV) positive individuals. Literature regarding the relative contribution of EPTB to the total number of cases of tuberculosis is lacking and hence there is no reliable epidemiological data. Due to the stigma associated with and the reluctance to perform invasive procedures especially in HIV positive patients, the notified estimates of EPTB under the Revised National Tuberculosis Programme (RNTCP) are often based on presumptive diagnosis and are an over estimate of the problem.