Reactivation of Tuberculosis: A Problem of Aging

Dubrow, Edward L.

doi:10.1111/j.1532-5415.1976.tb03269.x

Cited by 21 publications

(11 citation statements)

References 3 publications

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“…A large pool of latent tuberculosis have been reported in an earlier nationwide community study in Saudi Arabia. [18] And this is more likely to be the source of possible reactivation taken place in older ages. [19].…”

Section: Discussionmentioning

confidence: 99%

Incidence of and Risk Factors Associated with Pulmonary and Extra-Pulmonary Tuberculosis in Saudi Arabia (2010–2011)

et al. 2014

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SettingNational Tuberculosis Program, Department of Public Health, Ministry of Health, Kingdom of Saudi Arabia (KSA).ObjectiveTo summarize data on the incidence of tuberculosis and associated risk factors for cases reported during 2010–2011.DesignRetrospective analysis of routinely collected data through an established national disease notification system of the Ministry of Health in KSA.ResultsThe estimated incidence of all forms of tuberculosis fell from 15.8/100000 (95% CI: 15.3/100,000–16.3/100,000) in 2010 to 13.8/100,000 (95% CI: 13.4/100,000–14.2/100,000) in 2011. Saudis experienced a decrease from 11.8/100,000 (95% CI: 11.3/100,000 to 12.3/100,000) in 2010 to 9.9/100,000 (95% CI: 9.5/100,000–10.4/100,000) in 2011 while the incidence in non-Saudis declined from 24.7/100,000 (95% CI: 23.6/100,000 to 25.7/100,000) in 2010 to 22.5/100,000 (95% CI: 21.5/100,000 to 23.4/100,000) in 2011. The proportion of Extra Pulmonary TB (EPTB) which increased minimally from 30% in 2010 to 32% in 2011 was higher than global figures and strongly associated with age, sex, nationality and occupation.ConclusionThe current estimated incidence of about 14/100,000 in 2011 is less than half its estimated value of 44/100000 in 1990. Without prejudice to any under-reporting, the KSA appeared to be on the course for TB elimination by 2050 having reached the first milestone set by WHO. The proportion of EPTB remains higher than global figure and age, sex, nationality and occupation were significant independent predictors of EPTB.

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Section: Discussionmentioning

confidence: 99%

Incidence of and Risk Factors Associated with Pulmonary and Extra-Pulmonary Tuberculosis in Saudi Arabia (2010–2011)

et al. 2014

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“…[15] This large pool of latent TB is likely to be the source of active TB in adults and would explain the high incidence rate of the disease in the older age groups. [16]…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis incidence trends in Saudi Arabia over 20 years: 1991-2010

et al. 2013

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OBJECTIVE:To evaluate tuberculosis (TB) incidence rates and trends over a period of 20 years (1991-2010) and assess the impact of the National TB Control Program (NTP) on incidence trends.METHODS:This is a retrospective study of TB surveillance data reported by the Ministry of Health. We evaluated TB incidence data by nationality, age, and region of the country and assessed incidence trends over 20 years of study. Chi-squared test was used to assess trend change and its significance.RESULTS:There were a total of 64,345 reported TB cases over the study period. Of these 48% were Non-Saudis. TB annual incidence rate ranged between 14 and 17/100,000. For Saudis, the rate ranged between 8.6 and 12.2/100,000. Non-Saudis had 2-3 times higher incidence. Disease trend was rising over the first 10 years of the study period then it started to fall slightly. The incidence increased with age, but only people older than 45 years showed a declining trend. Regional variations were observed. Makkah and Jazan regions had the highest incidence rates. Disease trends were rising over the last 10 years in Makkah and Central regions.CONCLUSION:TB control seems to be facing some challenges in several regions of the Kingdom. NTP needs to evaluate and improve TB control strategies in order to reduce disease incidence to elimination levels.

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“…Many of the current cohort of elderly acquired infection in their early years, before effective treatment or BCG vaccine was available, and it has been estimated that approximately 90% of the cases with tuberculosis in the older age group are the result of reactivation of a primary infection [7], The problem of tuberculosis among the elderly living in chronic care facili ties may be expected to be greater than in the community as a result of communal living and is documented by the large survey of 31,421 subjects living in such facilities in Arkansas, USA [8]. Institutionalization is considered to be a predisposing factor to tu berculosis in the elderly.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis among Elderly Chinese in Residential Homes: Tuberculin Reactivity and Estimated Prevalence

Woo¹,

Chan²,

Hazlett³

et al. 1996

Gerontology

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Objectives of this study were to determine the prevalence of positive tuberculin reactivity and associated factors among elderly nursing home residents in a population with a relatively high tuberculosis notification rate, to estimate the prevalence of active tuberculosis, and to assess tuberculin reactivity as a screening tool. A stratified, disproportional, randomized cluster sample of residents was selected and the Mantoux test (using 0.1 ml of 5 tuberculin units of purified protein derivative of tuberculin) carried out. All subjects with a positive test had a chest X-ray followed by sputum smear and culture if the X-ray was abnormal. Sputum examination was also carried out in a random sample of controls, matched for age and gender, drawn from subjects with a negative Mantoux test. Information regarding medical history, tobacco smoking habits, symptoms related to tuberculosis, and communal eating habits were gathered. Also anthropometric data were collected. Sixteen nursing homes in the catchment area of a major district hospital in Hong Kong comprising 587 residents (136 men, 451 women, mean age 80 ± 8 years) participated in this study. The weighted prevalence of tuberculin reactivity was 43.8%. It was higher in men, among those who took their meals in a common area, in the younger age group, and in those with no previous history of hospitalization. No association was found between prevalence and duration of residence, smoking, skinfold thickness, past medical history, or any relevant symptoms. Following radiological and sputum examination, the estimated prevalence of active tuberculosis ranged from 1.2 to 2.6%. The sensitivity of the tuberculin test was 86, the specificity 30%. The prevalence of active tuberculosis in nursing homes in Hong Kong is high, but it is unclear whether cross-infection or poor health of the residents is the major contributing factor. Tuberculin skin testing does not appear to be a useful screening method in this population.

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Reactivation of Tuberculosis: A Problem of Aging

Cited by 21 publications

References 3 publications

Incidence of and Risk Factors Associated with Pulmonary and Extra-Pulmonary Tuberculosis in Saudi Arabia (2010–2011)

Incidence of and Risk Factors Associated with Pulmonary and Extra-Pulmonary Tuberculosis in Saudi Arabia (2010–2011)

Tuberculosis incidence trends in Saudi Arabia over 20 years: 1991-2010

Tuberculosis among Elderly Chinese in Residential Homes: Tuberculin Reactivity and Estimated Prevalence

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