Navigating The Complexities Of Extrapulmonary Tuberculosis: Clinico-Epidemiological Profile, Diagnostic & Therapeutic Challenges As Perceived By Treating Doctors In A Tertiary Care Hospital: A Mixed Method Study

Background:Extrapulmonary tuberculosis (EPTB) presents unique clinical and diagnostic challenges due to its varied manifestations and often nonspecific symptomatology. Timely diagnosis and effective management are crucial to prevent complications and ensure favorable outcomes. This study aimed to examine the clinicoepidemiological profile of EPTB and explore the diagnostic and therapeutic challenges perceived by healthcare providers in a tertiary care hospital setting. Methods:A mixed-methods study was conducted over a six-month period from June to December 2024. The quantitative component included retrospective data collection from medical records of 90 patients diagnosed with EPTB. Data on demographic characteristics, clinical presentations, and diagnostic methods were analyzed. The qualitative component involved in-depth interviews with eight doctors from various clinical departments to gather insights into their experiences, challenges, and perceptions regarding the management of EPTB. Results:Of the 90 EPTB cases, 40% were in the age group of 35–54 years. Female patients constituted a slight majority (53.3%). Abdominal tuberculosis emerged as the most common form of EPTB, observed in 48% of patients. Interviews with healthcare providers revealed key challenges, including delayed diagnosis due to atypical presentations, limited sensitivity of conventional diagnostic tools, drug resistance, and poor drug penetration in specific tissues. Variability in treatment practices and the need for standardized protocols were also highlighted. Conclusion:The study underscores the complex nature of EPTB diagnosis and treatment. Strengthening clinician training, adopting standardized diagnostic algorithms, and integrating molecular diagnostics are essential to improve patient care. A multidisciplinary and collaborative approach is recommended to overcome existing barriers.