Detection of genital tuberculosis among women with infertility using best clinical practices in India: An implementation study.
Indian J Tuberc
; 68(1): 85-91, 2021 Jan.
Article
em En
| MEDLINE
| ID: mdl-33641856
ABSTRACT
BACKGROUND:
Diagnosis of genital tuberculosis (TB) as a cause of infertility still remains a diagnostic dilemma for clinicians, as no standard guidelines exist. The recently proposed best practices for genital TB diagnosis have not been evaluated yet in India.OBJECTIVES:
To implement best practices to diagnose and treat likely genital TB as a cause of infertility.METHODS:
Between April 2016 and June 2018, consenting women seen at a tertiary hospital infertility clinic were assessed by thorough TB related clinical history, ultrasonography, tuberculin skin test (TST), and ESR. Those with suspected genital TB underwent laparohysteroscopy. Clinical and laboratory characteristics were compared between likely (microbiologically confirmed or probable TB) and unlikely (possible and no genital TB) genital TB. Fertility outcome was assessed among women initiated on anti-TB treatment (ATT).RESULTS:
Of 185 women seeking infertility care, likely genital TB was identified among 29 (15.7%) women, with 6 (21%) confirmed and 23 (79%) probable genital TB. Compared to unlikely genital TB cases, the likely genital TB group were found to have past history of TB (p < 0.001); positive TST (p = 0.002) and elevated ESR (p = 0.001). Among the likely genital TB group, all 6 confirmed genital TB were started on ATT and 2 (33.3%) conceived. Of 5 probable genital TB started on ATT, 3 (60%) conceived.CONCLUSION:
Approximately 1/6th of women seeking infertility care met the criteria for likely genital TB. Conception among over-half of treated probable genital TB cases provides preliminary evidence that best clinical practices can be utilized, but needs further confirmatory studies.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tuberculose dos Genitais Femininos
/
Infertilidade Feminina
Tipo de estudo:
Diagnostic_studies
/
Guideline
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Observational_studies
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Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
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Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Indian J Tuberc
Ano de publicação:
2021
Tipo de documento:
Article