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dc.contributor.authorJørstad, Melissa Davidsen
dc.contributor.authorDyrhol-Riise, Anne Ma
dc.contributor.authorAßmus, Jörg
dc.contributor.authorMarijani, Msafiri
dc.contributor.authorSviland, Lisbeth
dc.contributor.authorMustafa, Tehmina
dc.identifier.citationJørstad MD, Dyrhol-Riise AM, Aßmus J, Marijani M, Sviland L, Mustafa T, Mustafa. Evaluation of treatment response in extrapulmonary tuberculosis in a low-resource setting. BMC Infectious Diseases. 2019;19:426eng
dc.description.abstractBackground Diagnosing extrapulmonary tuberculosis (EPTB) is challenging and many patients are initiated on empirical anti-TB treatment without a laboratory confirmed diagnosis. Monitoring treatment response is thus important to ensure correct diagnosis and proper disease management. The definition of satisfactory response to treatment in EPTB remains unclear. The objectives of this study were to describe the clinical presentation of EPTB and the effect of treatment on clinical parameters. Further, to assess if simple clinical parameters, without laboratory data, could evaluate treatment response. Methods Prospective cohort study of presumptive EPTB patients at Mnazi Mmoja Hospital, Zanzibar. By using a composite reference standard, patients were categorized as TB or non-TB cases. The TB patients were followed during anti-TB treatment. Results There were 64 TB and 62 non-TB cases. The frequency of symptoms at baseline were comparable in TB and non-TB patients, with lymphadenitis and pleuritis as the most common manifestations. Among TB cases, there was a trend towards regression of lymphadenopathy after 2 months, and at treatment completion 24/28 (86%) cases showed full regression. Weight gain ≥5% was reported in 36/49 (73%) of the TB patients at 2 months and in 38/46 (83%) at treatment completion. After 2 months of treatment, a combination of clinical parameters; improvement of symptoms (50/50), ≥5% weight gain (36/49) and regression of physical signs (45/49) correlated with the treatment response. Conclusions An algorithm including only simple clinical parameters could be used as an easy tool to assess treatment responses in low-resource settings. However, this needs to be tested on a larger sample size.eng
dc.rightsAttribution CC BYeng
dc.subjectTreatment outcomeeng
dc.subjectClinical parameterseng
dc.subjectWeight gaineng
dc.subjectTuberculous lymphadenitiseng
dc.subjectTuberculous pleuritiseng
dc.titleEvaluation of treatment response in extrapulmonary tuberculosis in a low-resource settingeng
dc.typeJournal articleeng
dc.subject.nsiVDP::Medisinske fag: 700
dc.subject.nsiVDP::Midical sciences: 700
dc.rights.holderCopyright 2019 The Authorseng
bora.peerreviewedPeer reviewedeng
dc.type.documentJournal article
dc.relation.projectIDNorges forskningsråd: 234457
dc.relation.journalBMC Infectious Diseases

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