Context
Extra-pulmonary tuberculosis (EPTB) refers to tuberculosis infections that occur outside of the lungs. While pulmonary TB is more common and contagious, EPTB presents unique challenges in diagnosis and treatment due to its varied manifestations in different organs of the body.
Epidemiology of EPTB
- About 20% of TB worldwide is EPTB, which condition percentage is the highest in the weakened immune individuals.
- According to the statistics provided by the World Health Organization, every year there are over 10 million new TB cases. India is the largest share with 27% of all TB burden.
Diagnostic Challenges
- EPTB may be difficult to spot because it is devoid of stains – which is normal for regular TB stain tests. Its symptoms can be severe enough to resemble another non-TB type of condition phenotype, resulting in wrong diagnosis and overdiagnosis.
- Insufficient precision of clinical criteria for epidemiological study, in fact, makes it difficult to diagnose EPTB.
Treatment Difficulties
- Managing EPTB is complicated by the long-term antibiotic treatments, the possibility of resistance and the need for sustained supervisory time.
- EPTB have various forms unlike tuberculosis and this poses another challenge as standardised treatment protocols have not been developed yet.
Challenges in Addressing EPTB
- Although addressing extrapulmonary tuberculosis (EPTB) is difficult due to lack of knowledge among health workers and absence of proper directions of diagnosis and treatment, a joint effort from Government and stakeholders can work towards crucial solutions to these problems.
- Together with resolving infection sites in the different organs by designing specific drugs, many health providers are as well unaware of this and diagnosis is either delayed or missed.
- Nothing else but the ambiguity and multitudes of tuberculosis manifestations can even obstruct this simple diagnostic and treatment procedure among those knowledgeable about the disease.
- Thus the lack of informal rules of interdisciplinary communication completely worsens the organisational flow of EPTB.
- In the year 2014, the experts combined to make the guidelines on managing EPTB in India, and these have not yet been lucratively used.
- An integrated framework be swiftly put forward to deal with the issue of EPTB, which is more common in heavily TB-affected nations, particularly India.
Public Health Implications
- The failure to respond properly to EPTB is likely to cause permanent damage to the organs affected by the disease.
- Resolution of EPTB implies effective TB control in an integral way and needs integrated efforts including awareness campaigns, early detection and treatment.
Policy and Programmatic Responses
- India’s National TB Program envisions TB elimination by 2025 which most likely will happen. Nevertheless, a plan pointing to particular solutions for EPTB would be more efficient to end the problem.
- Combining health institutions’ efforts and INDEX-TB framework invention can be regarded as the beginning of a new dawn.
Way Forward
- Data collection, involving data drawing and keeping of records at the same time from different sources takes place. The prompt data and methodical collection from the hospital systems are a must for studying and managing the extrapulmonary tuberculosis (EPTB).
- These departmental authorities maintain separate data approaches which are not amalgamated to produce the large overall EPTB pattern.
- The areas that are still shrouded in mystery of research on extrapulmonary tuberculosis (EPTB) such as the way the infection spreads and the interaction of the TB bacterium with our organs remain. Identical immune reactions onto appearance of the disease in other organs and increase in the duration of the illness.
- At the centre of researchers’ approach is the quest to elucidate these functions and find ways to enhance therapy outcomes. The key is to develop unified approaches for the diagnosis and treatment of extensively drug-resistant TB.
- EPTB requires the much sophisticated standardised diagnosis and treatment protocols for all the body organs affected by EPTB, as at present, the current guidelines does not include any update with the latest multidisciplinary findings.
Source: The Hindu
UPSC Prelims Practice Question
Q. Which of the following statements about Extra-Pulmonary Tuberculosis (EPTB) is correct?
a) It only affects the lungs.
b) It primarily affects the brain and spinal cord.
c) It involves tuberculosis infection in organs other than the lungs.
d) It is caused by a different bacterium than Pulmonary Tuberculosis.
Ans- “c”
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