A PROSPECTIVE STUDY TO EVALUATE THE TREATMENT OUTCOME OF TUBERCULAR PLEURAL EFFUSION REGISTERED UNDER NATIONAL TUBERCULOSIS ELIMINATION PROGRAMME

Background: Tuberculosis is the leading etiology of pleural effusion in developing countries. Administration of anti-tubercular therapy (ATT) cures tuberculous pleural effusion and reduces the incidence of subsequent TB, hence it is important to establish the diagnosis of tuberculous pleural effusion and initiate the proper treatment. This study aims to assess the treatment outcome of tubercular pleural effusion patients treated under NTEP. Material & Methods: A prospective study was done on 72 patients attending with pleural effusion at IRD, SMS Medical College, Jaipur after applying inclusion and exclusion criteria from April 2021 to March 2022. The patients included were diagnosed completely by collecting their detailed history, clinical examination, routine blood investigations, sputum examination, chest X-rays, ultrasound of thorax and pleural uid analysis. Data from the study were collected, tabulated and analyzed statistically using SPSS version 22.0 for data processing and statistics. The following tests were used t-test, Chi-Square (x2), and Logistic regression analysis.Results: Our study showed that 62.5% of patients reside in rural areas and 37.5% of patients were resides in the urban area. Most patients were Hindus (86.11%) and 16.66% were Muslims. They were mostly married. On the estimation of pleural uid protein, 66 (91.66%) patients were having pleural uid protein values of more than 3.0 g/dl. Our study showed that 30 (41.66%) were reported as having ADAin the ranges 40-60 U/L, 22 patients having 60.1-80U/L and only 4 patients had >100U/L. In the present study, the random blood sugar observed was >200 mg/dl in 4.16% of the patients with TPE. After treatment, 1 patient died during the course of treatment, 9 loss to follow-up, 7 were abnormal in chest x-ray and 2 did not attend for X-ray in our study. Conclusion: The denitive diagnosis of TB pleural effusions depends on the demonstration of M tuberculosis in sputum, pleural uid, or pleural biopsy specimens. Supportive evidence includes the demonstration of classical TB granulomas in the pleura and elevated adenosine deaminase (ADA) in pleural uid. Clinical prole &chest X-ray showed marked improvement on NTEP regimen. Hence our study also supports better treatment outcomes on NTEPregimen in tubercular pleural effusion.