A study to know the prevalence of genital tuberculosis in female’s pulmonary tuberculosis patients and role of cartridge based nucleic acid amplification test in genital tuberculosis from North India

Anand Kumar; Aparjot Singh; Sudhir Chaudhri; Sanjay Kumar Verma; Kiran Pandey; Mahendra Singh; Surya Kant

doi:10.18203/2320-6012.ijrms20210413

Authors

Anand Kumar Department of Tuberculosis and Respiratory Diseases, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Aparjot Singh Department of Respiratory Medicine, Adesh Medical College, Shahbad, Kurukshetra, Haryana, India
Sudhir Chaudhri Department of Tuberculosis and Respiratory Diseases, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Sanjay Kumar Verma Department of Tuberculosis and Respiratory Diseases, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Kiran Pandey Department of Obstetrics and Gynaecology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Mahendra Singh Department of Pathology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Surya Kant Department of Pulmonary Medicine, King Georges Medical University, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20210413

Keywords:

Pulmonary tuberculosis, Female genital tuberculosis, CBNAAT

Abstract

Background: Mycobacterium tuberculosis, most commonly, infects the lungs (pulmonary TB). Most cases of female genital TB (FGTB) are found in premenopausal women, theoretically because an atrophic endometrium provides a poor milieu for mycobacterial growth. Female genital TB generally occurs secondary to pulmonary (commonest) and more common in women with reproductive age group. The present study was designed to know the prevalence of genital tuberculosis in female’s pulmonary tuberculosis patients and role of cartridge based nucleic acid amplification test (CBNAAT) in genital tuberculosis.

Methods: The patients of female’s pulmonary tuberculosis were picked up from out-patient and in patients’ section of the hospital at random. After ruling out pregnancy, the endometrial samples were collected from premenstrual endometrium (approximately 2-3 days before menstruation) and were subjected to histopathological examination and CBNAAT. Day 1 or 2 menstrual blood of unmarried females and patients not giving consent for biopsy were taken.

Results: Seventy married and 20 unmarried patients of female pulmonary tuberculosis patients were evaluated for genital tuberculosis. The mean age of married population was 29±7.68 years. Cough with expectoration was most common respiratory symptoms and seen in 94% cases. In present study 89% cases were sputum positive and 11% were sputum negative. The percentage of non MDR and MDR TB cases were respectively 95.7 and 4.2% respectively. Among the gynecological symptom’s irregular menstruation, vaginal discharge and pelvic pain were present in 68, 60 and 52% of the study patients respectively. The diagnosis of FGTB by histopathology examination and CBNAAT were 28.6 and 17.1% respectively.

Conclusions: In present study FGTB diagnosed by histopathology examination and CBNAAT were 28.6 and 17.1% respectively and which was statistically significant (c²=28.25 and p value=0.00001).

Metrics

Metrics Loading ...

References

Mazumdar S, Satyanarayan S, Madhukar P. Self-reported tuberculosis in India. BMJ Global Health. 2019;4:1-8.

World Health Organization. Global tuberculosis report. Geneva. WHO. 2018.

Kumar S. Female genital tuberculosis. In: Sharma SK, Mohan A, editors. tuberculosis. 3rd ed. Delhi: Jaypee Brothers Medical Publisher Ltd. 2015;311-24.

Schaefer G. Female genital tuberculosis. Clin Obstet Gynaecol. 1976;19:223-39.

Gupta N, Sharma JB, Mittal S, Singh N, Misra R, Kukreja M. Genital tuberculosis in Indian infertility patients. Int J Gynecol Obstet. 2007;97:135-8.

Oosthuizen AP, Wessels PH, Hefer JN. Tuberculosis of the female genital tract in patients attending an infertility clinic. S Afr Med J. 1990;77:562-4.

Tripathy SN, Tripathy SN. Infertility and pregnancy outcome in female genital tuberculosis. Int J Gynecol Obstet. 2002;76:159-63.

Jindal UN. An algorithmic approach to female genital tuberculosis causing infertility. Int J Tuberc Lung Dis. 2006;10:1045-50.

Parikh FR, Nadkarni SG, Kamat SA, Naik N. Genital tuberculosis-a major pelvic factor causing infertility in Indian women. Fertil Steril. 1997;67:497-500.

Grace GA, Devaleenal DB, Natrajan M. Genital tuberculosis in females. Indian J Med Res. 2017;145:425-36.

Qureshi RN, Samad S, Hamid R, Lakha SF. Female genital tuberculosis revisited. J Pak Med Assoc. 2001;51:16-8.

Neonakis IK, Spandidos DA, Petinaki E. Female genital tuberculosis: a review. Scand J Infect Dis. 2011;43:564-72.

Sharma JB. Tuberculosis and obstetric and gynecological practice. In: Studd J, Tan SL, Chervenak FA, editors. Progress in obstetric and gynaecology. Philadephia: Elsevier. 2008;48:395-427.

Jahromi NB, Parsanezhad ME, Ghane-Shirazi R. Female genital tuberculosis and infertility. Int J Gynaecol Obstet. 2001;75:269-72.

Mondal SK. Histopathological analysis of Female genital tuberculosis: A fifteen-year retrospective study of 110 cases in Eastern India. Turkish J Pathol. 2013;29:41-5.

Boehme CC, Nabeta P, Hillemann D. Rapid molecular detection of tuberculosis and rifampin resistance. N Engl J Med. 2010;363:1005-15.

Lawn SD, Nicol MP. Xpert (R) MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance. Future Microbiol. 2011;6:1067-82.

WHO. Xpert MTB/RIF system for the diagnosis of pulmonary and extrapulmonary TB in adults and children: policy update. Geneva, World Health Organization, 2013. Available at http://www.who.int/tb/laboratory/policy_statements/en/. Accessed on 12 Nov, 2020.

Sharma JB, Sharma E, Sharma S, Dharmendra S. Female genital tuberculosis: Revisited. Indian J Med Res. 2018;148:71-83.

Carter JR. Unusual presentations of genital tract tuberculosis. Int J Gynaecol Obstet. 1990;33:171-6.

Thangappah RBP, Paramasivan CN, Narayanan S. Evaluating PCR, culture and histopathology in the diagnosis of female genital tuberculosis. Ind J Med Res. 2011;134:40-6.

Shahzad S. Investigation of the prevalence of female genital tract tuberculosis and its relation to female infertility: An observational analytical study. Iran J Reprod Med. 2012;10:581-8.

Prasad S, Singhal M, Negi SS, Gupta S, Singh S, Rawat DS et al. Targeted detection of 65 kDa heat shock protein gene in endometrial biopsies for reliable diagnosis of genital tuberculosis. Eur J Obs Gynecol Reprod Biol. 2012;160:215-8.

Patil AD, Shinde SK, Sachdeva GM, Pasi AR, Chitlange SM, Chandhiok N et al. Is testing of menstrual blood justifiable for diagnosis of endometrial tuberculosis among infertile women? Indian J Obstetr Gynecol Res. 2015;2:103-7.

Mani R, Nayak S, Kagal A, Deshpande S, Dandge N, Bharadwaj R. Tubercular endometritis in infertility: A bacteriological and histopathological study. Indian J Tuberc. 2003;50:161.

Kumar P, Shah NP, Singhal A, Chauhan DS, Katoch VM, Mittal S. Association of tuberculous endometritis with infertility and other gynecological complaints of women in India. J Clin Microbiol. 2008;46:4068-70.

Kohli MD, Nambam B, Trivedi SS, Sherwal BL, Arora S, Jain A. PCR based evaluation of tubercular endometritis in infertile women of North India. J Reprod Infertil. 2011;12:9-14.

Goel G, Khatuja R, Radhakrishnan G, Agarwal R, Agarwal S, Kaur I. Role of newer methods of diagnosing genital tuberculosis in infertile women. Indian J Pathol Microbiol. 2013;56:155-57 .

Shende P, Valecha SM, Gandhewar M, Dhingra D. Genital tuberculosis and infertility. Int J Reprod Contracept Obstet Gynecol. 2017;6(8):3514-7.

Rozati R, Roopa S, Rajeshwari CN. Evaluation of women with infertility and genital tuberculosis. J Obstet Gynecol India. 2006;56(5):423-6.

Aka N, Vural EZT. Evaluation of Patients with Active Pulmonary Tuberculosis for Genital Involvement. J Obstetr Gynaecol. 1997;23:337-40.

Eryani AAA, Abdelrub AS, Harazi AHA. Genital tuberculosis is common among females with tubal factor infertility: Observational study. Alexandria J Med. 2015;51(4);321-4.

Shrivastava G, Bajpai T, Bhatambare GS, Patel KB. Genital tuberculosis: Comparative study of the diagnostic modalities. J Human Reprod Sci. 2014;7:30-3.

Sindhoora B, Anjum N. Comparison of Effectiveness of Menstrual Blood Sample and Endometrial Biopsy Sample for TB-PCR Test for Detection of Tuberculous Endometritis. J Cont Med A Dent. 2016;4:19-23.