Tuberculose du sujet âgé

Profile and Treatment Outcomes of Tuberculosis in the Elderly in Southeastern Nigeria, 2011–2012

“…This supports the finding of other studies in Africa, Asia, North America, and Europe [4], [10]–[12], [14]–[17], [19]. The higher deaths observed among elderly TB patients may be due to increased levels of co-morbid conditions and factors like diabetes mellitus, hypertension, excess alcohol use, smoking and cardiovascular diseases in this age-group as well as higher proportion of patients with advanced disease in the elderly [16], [19], [33]. Given that this is a retrospective review of TB registers, we could not assess the extent of these problems and their impact on treatment outcomes.…”

“…With the increasing life expectancy in Africa [9], our finding suggests that TB in the elderly is a major issue that needs to be tackled in order to have a successful TB control programme. Consistent with earlier findings [4], [14], [16], [19], we found that elderly men had a higher rate of TB compared with women; this highlights the increased risk of the disease in elderly men in Nigeria. This finding follows the epidemiologic trend of TB in Nigeria [21].…”

“…The proportion of TB occurring in elderly patients in this study (12.7%) is comparable to the findings of studies in Senegal where the prevalence was 12.8% [19], as well as in India where the rates ranged between 14–16.6% of all TB cases [16]–[17]. But, our findings did not agree with results from Germany and a tertiary setting in India where TB in the elderly accounted for 36% and 4.2% of TB cases respectively [15], [24].…”

“…Assessment and recording of co-morbidities like diabetes mellitus should be included routinely in the management of TB as this will ensure early management of this co-morbidity with TB. The higher rates of treatment default in the elderly may be due to poor memory of appointment dates, higher adverse drug reactions leading to poorer adherence to treatment, co-morbid diseases and inability to visit the treatment centres due to absence of a family member that accompanies them to the treatment centre [16], [19]. Given that more than four fifths of the elderly patients in this study resided in the rural area, treatment default in the elderly may be lowered by providing quality geriatric health services at the primary care level to address the varying needs of the elderly patients in rural settings of Nigeria.…”

“…To date, several published studies have reported on TB and its treatment outcomes in the elderly in India, Taiwan, Hong Kong, U.S.A, Mexico, Brazil and Germany [3]–[4], [10]–[12], [14]–[18]. Data from African populations have been scarce [19]. To optimize healthcare services and TB control in resource-poor settings of Africa, detailed knowledge of the epidemiological features of TB and its treatment outcomes in the elderly in the region are needed.…”