Lymph Node Tuberculosis in an Urban Setting in Eastern India during 2016–2024

study period of approximately 9 years (February 2016 to December 2024).For a small subset of positive samples for which line probe assay (LPA, MTBDRplus, Hain Life Science, Germany) results were available, we evaluated the sensitivity to RIF and isoniazid (INH). Materials a n d MethodsThe study was conducted in Bhubaneswar, which is the capital city of Odisha state in eastern India.The city has a population of about 8.5 lakhs according to the 2011 census, and in addition, approximately 25,000-30,000 floating population daily.Bhubaneswar is the medical hub of Odisha and has multiple primary, secondary, and tertiary healthcare facilities (clinics, urban healthcare centers, introduction According to the Global Tuberculosis Report 2023 by the World Health Organization (WHO), about 7.5 million people were newly diagnosed with tuberculosis in 2022. 1 India contributed to 27% of the newly diagnosed TB cases globally in 2022. 1 Lymph nodes are among the most common sites for extrapulmonary tuberculosis (EPTB), and lymph nodes also serve as niches for the growth and persistence of Mycobacterium tuberculosis (Mtb). 2 The diagnosis of lymph node tuberculosis remains challenging, and the routinely used methods (smear microscopy and cytology) have low sensitivity. 3 Xpert MTB/RIF (Cepheid Inc., Sunnyvale, USA) is an automated real-time cartridge-based nucleic acid amplification test (CBNAAT) that is used to detect and identify Mtb complex along with RIF resistance (rpoB gene) to improve the sensitivity and hasten the diagnosis of tuberculosis. 4Xpert MTB/RIF has been recommended by the WHO for the diagnosis of Mtb in pulmonary and extrapulmonary samples, including tuberculous lymphadenitis. 2,5 In 2016, a substantial number of CBNAAT equipment (Xpert MTB/RIF, Sunnyvale, USA) were rolled out across the country as envisaged in the National Strategic Plan for tuberculosis control during 2012-2017.In February 2016, one Xpert MTB/RIF equipment was installed at the National Reference Laboratory for Tuberculosis in Bhubaneswar for tuberculosis diagnosis.This retrospective study was carried out to estimate the burden of lymph node-associated tuberculosis and resistance to RIF in presumptive tuberculosis patients in Bhubaneswar, the capital city of Odisha state, during the 1-