La tuberculose du sujet âgé : quelles particularités liées à l’âge ?

Maddeh, Sabrine; Bouani, Kais; Jlaiel, N.; Khraifi, Mohamed; Jdidi, T.; Oueslati, B.; Àouadi, S.

doi:10.1016/j.rmra.2021.11.263

Cited by 1 publication

(3 citation statements)

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“…Complications were noted in our study in 31.88% (n=22) of patients. Maddeh [39] and Marniche [49] in Tunisia reported a higher rate of complications, with 78% and 72% respectively. The occurrence of complications is attributable not only to ageing, but also to the problems of managing the geriatric population, which often suffers from many comorbidities.…”

Section: Evolutionary Aspectsmentioning

confidence: 94%

“…A descriptive study of a cohort of 100 patients aged 50 in Himachal Pradesh found 68% to be smokers [38]. Toure [26] reported smoking in 50% of patients and alcoholism in 20.8%, and Maddeh in Jendouba, Tunisia, 46% [39]. In contrast, Mejdoub et al [40] in Tunis reported a 100% frequency of tobacco intoxication.…”

Section: Epidemiological Aspectsmentioning

confidence: 99%

“…Similar findings were reported by Tidjani et al in Togo (93.3%) [32], Loudadsi in Morocco (98%) [37], and Toure [26] in Dakar among patients living with HIV (100%). However, Majdoub and Maddeh in Tunis found lower prevalence rates, with values of 55% and 14%, respectively [39][40].…”

Section: Clinical Aspectsmentioning

confidence: 99%

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Pulmonary Tuberculosis in the Elderly: Epidemiological, Clinical, and Evolutionary Aspects

Ngom N F,

Mbaye B R,

Ndiaye A

et al. 2024

AJRID

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Aims: this study aimed to investigate the epidemiological, clinical, and evolutionary aspects of pulmonary tuberculosis in the elderly and to determine the factors associated with death. Study Design: This was an exhaustive, descriptive, and analytical retrospective study. Place and Duration of Study: Pneumo-phtisiology department of Fann National Teaching Hospital Center over three years, from January 1, 2019, to December 31, 2021. Methodology: This was a study using medical records of patients aged 60 and over hospitalized in the pneumo-phtisiology department. Data were collected on a pre-established from patient medical records entered with Microsoft Excel 2019 software. Data analysis was performed with Statistical Package for Sciences Socials (SPSS) version 18 Results: we collected 620 medical records of hospitalized patients aged 60 and over, 69 of whom were diagnosed with pulmonary tuberculosis, standing for a prevalence of 11.12%. The average age was 67.13 [60;85] years, with a sex ratio of 3.92. The 60 to 65 age group was the most represented (n=36 or 52.17%). Smoking and alcoholism were frequent, 82% and 17.4% respectively. A previous history of TB infection was found in 23.19% of cases and TB contagion in 20.3% of cases. An underlying condition was at least observed in 50.72% of patients, dominated by diabetes (29%) and hypertension (23%). Co-infection with HIV-1 and tuberculosis was found in 2 patients (3%). The time to consultation was 75 days [3-180 days]. Symptomatology was polymorphic, dominated by cough (n=65; 94.20%), altered general condition (n=63; 91.30%), sputum (n=58; 84.06%), fever (n=53; 76.81%) and dyspnea (n=47; 68.12%). 46 patients (66.7%) had a BMI < 18.5 kg/m2. Physical signs were dominated by pulmonary condensation (n=52; 75.36%), and a fold of undernutrition was noted in 21.74% of cases. Microbiological evidence was 92.75% and 64 patients (92.75%) were susceptible to rifampin. A rifampin-resistant strain was detected in 5 patients (7.25%) hospitalized in the MDR-TB unit. CRP (75.36%), anemia (68.18%), hyperleukocytosis (47.7%), and hyponatremia (27.54%) were the most frequent biological signs. Alveolar syndrome (n=48 or 70%) and cavitary images (n=34 or 50%) were most frequently found on lung radiography, and for those who benefited from thoracic CT (n=36 or 52.17%), cavitary images were found in 24 cases (66.66%). Pulmonary embolism (n=9 cases, i.e. 40.9%), superinfection (n=4), and excessive hemoptysis (n=3) were the most frequent complications. The mean length of hospital stay was 17 days [3-58 days]. The 2RHZE/4RH protocol was used for 87%. Two patients were placed on a second-line anti-tuberculosis treatment protocol. Treatment was not specified in 7 patients (10.14%). The progression was favorable in 48 patients (69.56% of cases), with a case fatality rate of 30.44%. Dyspnea, chest pain, anemia, hyperleukocytosis, and hyponatremia were associated with the risk of death. Conclusion: The elderly are particularly exposed to tuberculosis, due to physiological aging of the immune system and co-morbidities. This study highlighted the diagnostic and evolutionary particularities of pulmonary tuberculosis in the elderly, as well as the associated fatal factors.

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Section: Evolutionary Aspectsmentioning

confidence: 94%

Section: Epidemiological Aspectsmentioning

confidence: 99%