The epidemiology of tuberculosis in Phuentsholing General Hospital: a six-year retrospective study.

Background: This study was carried out to describe the epidemiology and treatment outcomes of TB infection in Bhutan at Phuentsholing General Hospital (PGH). Retrospective analysis of TB data was carried out using data from the TB registry of PGH from 2004-2009. Comparisons were made between TB, clinical presentation, diagnosis, and outcomes amongst male and female.

Findings: A total of 735 patients were analyzed, 12.4% (91) of whom were children (≤ 14 years). The highest cases was reported in 2009 (148), lowest in 2004 (93). Males and females were equally infected with TB. The median age was 25 years, (range 11 months - 98 years; IQR = 20-35). Extra-pulmonary Tuberculosis (EPT) 62.6% (57) was the commonest form of TB in children. Pleural effusion was more common in males 62.8% (27) (p = 0.013). Smear positive pulmonary tuberculosis (SPPT) 54.3% (207) (p = 0.02) and treatment defaulted 84.2% (16) (p = 0.004) was higher in males. However, transfer-in cases 57.0% (90) (p = 0.036) and treatment outcome-failure 92.3% (12) (p = 0.002) were more in females than males. The cure rate for SPPT was 69.0% (293) and unknown treatment outcome for all forms of TB was 11.2% (82).

Conclusion: TB infection has increased over the study period; SPPT increased more than other two forms of TB. The majority of the TB patients were in the age group of 15-34 years. Males and females were equally infected with TB and children made up 12.4% of TB patients. The cure rate amongst SPPT was 69%, which is much lower than the national target of 85% set by National Tuberculosis Control Programme (NTCP). Further studies need to be undertaken to identify the risk factor for TB in the economically productive age group. There is a need for improvement in the services, recording and reporting so as to meet the target of cure rate of 85% in SPPT patients.