title: The burden and treatment outcomes of extra-pulmonary tuberculosis in Bhutan.
abstract: METHODS
  All tuberculosis (TB) registration sites in Bhutan.
  
  
  METHODS
  Cross-sectional study involving a retrospective review of TB registers and TB treatment cards.
  
  
  OBJECTIVE
  To determine: 1) the number and proportion of all TB cases registered as extra-pulmonary TB (EPTB) from 2001 to 2010, 2) the age and sex of the patients and the categories and types of EPTB registered in 2010, and 3) their treatment outcomes.
  
  
  RESULTS
  The proportion of all TB cases registered as EPTB over a period of 10 years varied from 30% to 40%. In 2010, 505 patients were registered with EPTB, of whom 50% were male, 21% were children, and 96% were new EPTB cases. TB lymph node enlargement and pleural effusion were the two most common types of EPTB, accounting for 67%, followed by abdominal TB and spinal/bone/kidney disease. The overall treatment success rate was 90%, and was generally similar with respect to sex, age and different types of EPTB.
  
  
  CONCLUSIONS
  Bhutan has a high proportion of patients registered as having EPTB, for whom treatment outcomes are satisfactory. Further work is needed to better understand how EPTB is diagnosed throughout the country.
authors.affiliation: Health Management and Information System, Ministry of Health, Thimphu, Bhutan.
authors.forename: T
authors.initials: T
authors.lastname: Jamtsho
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Malhotra
authors.affiliation: Department of Public Health, Ministry of Health, Thimphu, Bhutan.
authors.forename: D
authors.initials: D
authors.lastname: Wangchuk
authors.affiliation: Department of Medical Services, Ministry of Health, Thimphu, Bhutan.
authors.forename: U
authors.initials: U
authors.lastname: Dophu
authors.affiliation: Communicable Disease Division, Department of Public Health, Ministry of Health, Thimphu, Bhutan.
authors.forename: T
authors.initials: T
authors.lastname: Dorji
authors.affiliation: National Tuberculosis Control Programme, Department of Public Health, Ministry of Health, Thimphu, Bhutan.
authors.forename: T
authors.initials: T
authors.lastname: Dendup
keywords: Bhutan; EPTB; treatment outcomes; tuberculosis