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Why Extra-Pulmonary TB Not a Public Health Priority in India?
Extra-pulmonary TB is TB of any other part of body except lungs (TB in lungs is referred to as pulmonary TB). For public health reasons, governments want to find all cases of pulmonary TB as they are spreading TB through cough (infectious) – but cases of extra-pulmonary TB don't spread TB by coughing, and is not easy to transmit. Apparently pulmonary TB gains more public health priority from the governments. However, PLHIV are at an increased risk of developing extra-pulmonary TB - for instance, lymph node TB is common among PLHIV. To reduce TB related mortality in PLHIV, preventing, diagnosing and treating extra-pulmonary TB is as much a public health priority as pulmonary TB is.
According to the data of Revised National TB Control Programme (RNTCP) in India, out of the total new TB cases in first two quarters of 2008, 18% were of extra-pulmonary TB. Since 2004, cases of extra-pulmonary TB have increased by 3% in 2008, as per RNTCP data. Out of these extra-pulmonary TB, 30% were of pleural effusion, 10% abdominal TB, 8% bone TB, 47% lymph node TB, 2% TB meningitis and 3% TB elsewhere in body except lungs. More than 11,000 people had died due to extra-pulmonary TB (2005-07) in India alone.
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