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Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India

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Sharma, Surendra K, Ryan, Hannah, Khaparde, Sunil, Sachdeva, K S, Singh, Achintya D, Mohan, Alladi, Sarin, Rohit, Paramasivan, C N, Kumar, Prahlad, Nischal, Neeraj, Khatiwada, Saurav, Garner, Paul ORCID: https://orcid.org/0000-0002-0607-6941 and Tharyan, Prathap (2017) 'Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India'. Indian Journal of Medical Research, Vol 145, Issue 4, pp. 448-463.

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Abstract

Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB.
Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i) use of Xpert MTB/RIF in diagnosis, (ii) use of adjunct corticosteroids in treatment, and (iii) duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WF Respiratory System > Tuberculosis > WF 205.1 General coverage
WF Respiratory System > Tuberculosis > WF 300 Pulmonary tuberculosis
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.4103/ijmr.IJMR_1950_16
Depositing User: Christianne Esparza
Date Deposited: 15 Sep 2017 09:53
Last Modified: 06 Sep 2019 10:16
URI: https://archive.lstmed.ac.uk/id/eprint/7566

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