Tuberculosis in Older People: A Retrospective and Comparative Study from Hong Kong

Leung, Chi Chiu; Yew, Wing Wai; Chan, Chi Kuen; Chau, CH; Tam, Cheuk Ming; Lam, C.W.; Tam, Wai On; Lau, Kam Shing; Liu, Wai T.

doi:10.1046/j.1532-5415.2002.50308.x

Cited by 59 publications

(59 citation statements)

References 22 publications

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“…A lower sensitivity of TST among elderly subjects is well reported in previous studies [4,5,15]. In the current study, the lower percentage of tuberculin-positive subjects among those aged o65 yrs probably reflected lower test sensitivity, rather than lower prevalence of LTBI.…”

Section: Discussionsupporting

confidence: 75%

“…The actual sensitivity is unknown because of the absence of a gold standard. Reduced sensitivity of tuberculin with age has been reported among residents of residential homes [4] and elderly patients with culture-confirmed TB [5]. Smoking, alcohol use and body mass index have been found to be independent predictors of a positive tuberculin reaction among silicotic subjects [6], but this could reflect either higher prevalence of LTBI or underlying differences in the immune status.…”

mentioning

confidence: 99%

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Comparison of T-Spot.TB and tuberculin skin test among silicotic patients

Leung

Yam²,

Yew³

et al. 2008

European Respiratory Journal

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In the present study, T-Spot.TB and the tuberculin skin test (TST) were compared in the screening of latent tuberculosis infection among silicotic patients.A conditional probability model was used to compare the potential clinical utilities of T-Spot.TB and TST performed on 134 silicotic subjects from December 1, 2004 to January 31, 2007. Data from a historical cohort were also reanalysed for further comparison.Agreement with T-Spot.TB was best using a TST cut-off of 10 mm. Age o65 yrs independently predicted a tuberculin reaction ,10 mm (odds ratio53), but not a negative T-Spot.TB response. Lower measures of agreement were observed among current smokers and those aged o65 yrs. Tuberculin reaction size was well correlated with both early secretary antigenic target 6 and culture filtrate protein 10 spot counts, except among current smokers. Within the current estimates of sensitivity (88-95%) and specificity (86-99%) for T-Spot.TB, the positive likelihood ratio for T-Spot.TB test would be substantially higher (6.29-95.0 versus 1.65-1.94) and negative likelihood ratio substantially lower (0.05-0.14 versus 0.32-0.41) than the corresponding ratios for the tuberculin test. A low tuberculosis risk differential was similarly observed between tuberculinnegative and untreated tuberculin-positive subjects in the historical cohort.T-Spot.TB is likely to perform better than tuberculin test in the screening of latent tuberculosis infection among silicotic subjects.

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Section: Discussionsupporting

confidence: 75%

mentioning

confidence: 99%

Comparison of T-Spot.TB and tuberculin skin test among silicotic patients

Leung

Yam²,

Yew³

et al. 2008

European Respiratory Journal

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“…Hong Kong çalışmasında tedavi başarısı %72,5 iken, mortalite %16 bulunmuştur. 9 Japonya'da dokuz aylık tedavinin başarısı gençlerde %87, yaşlılarda %71, mortalite ise gençlerde %3, yaşlılarda %21 bulunmuştur. 27 Yakın zamanda ABD'de yapılan bir çalışmada, yaşlı hastalarda mortalitenin oldukça yüksek olduğu görülmüş (tanıda ölüm %7, tedavi sürecinde %21, gençlerde aynı oranlar %2 ve %7), tedaviyi ölmeden tamamlayan yaşlı hastalarda tedavi başarısı, gençlerle benzer bulunmuştur.…”

Section: Yaşlıhastadatüberküloztanıvetedavisiunclassified

“…[5][6][7][8] Radyolojik bulguların karşılaştırıl-dığı çalışmalarda, genç hastalarda TB'ye özgü üst zon tutulumu ve kavite görünümünün daha yüksek olmasına karşılık yaşlı hastalarda yaygın infiltrasyonlar ve alt zon tutulumu daha sıktır. [8][9][10][11] Ayrıca yaşlı hastalarda antitüberkü-loz ilaç yan etkilerine daha sık rastlanılmaktadır 9,12,13 ve mortalite daha yüksektir. 5,9,[14][15][16] Yaşlı hastalarda eşlik eden hastalıkların fazla olması nedeniyle tanı koyma süreleri uzamaktadır.…”

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Tuberculosis in the Elderly

Köksal¹

2012

Solunum

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ÖZET ABST RACTTuberculosis (TB) is an infectious disease that can affect people of any age, gender, or socioeconomic class. It is more prevalent in some sections of the population and this situation is taken under consideration in implementing TB control programs. While TB affects mostly the productive age groups in high prevalence countries, it remains an important challenge in the elderly in low prevalence countries. The atypical clinical and radiological presentation of TB in the elderly and comorbidities can lead to delayed diagnosis and appropriate treatment. Considering TB in differential diagnosis is the cornerstone of a rapid diagnosis. Management of active TB in the elderly does not differ fundamentally from that in younger patients. Standart treatment is used. The incidence of adverse effects is higher in the elderly compared to the younger patients. Successful treatment outcomes are lower and TB-related mortality is higher in the elderly patients. The diagnosis and treatment of latent TB infection should be considered in risk groups. To minimize the risk of hepatotoxicity, careful pretreatment assessment is needed to balance the benefit against this potential risk.

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Outcomes of tuberculosis treatment: a retrospective cohort analysis of smoking versus non-smoking patients in Penang, Malaysia

et al. 2010

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Background The association between tobacco smoking and tuberculosis (TB) is increasingly coming to light and the literature is laden with the evidence of this association. However, only a few observational studies specifically investigated the association between smoking and TB treatment outcomes. Aim and methods The present study aims to determine the prevalence of smoking among TB patients in Penang and to compare the treatment outcomes between smoking and non-smoking TB patients. A retrospective estimate of smoking prevalence among patients with TB and a retrospective cohort study comparing smoking and nonsmoking TB patients with regards to treatment outcomes was conducted. The data were extracted from medical records of newly diagnosed TB patients who registered at a chest clinic at a tertiary care hospital in the state of Penang, Malaysia

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Tuberculosis in Older People: A Retrospective and Comparative Study from Hong Kong

Abstract: Substantial differences were found between older and younger TB patients. Many of these were associated with unfavorable outcome. Increased awareness in disease recognition and better medical and social support are therefore needed in addressing the growing problem of TB in older people.

Cited by 59 publications

References 22 publications

Comparison of T-Spot.TB and tuberculin skin test among silicotic patients

Comparison of T-Spot.TB and tuberculin skin test among silicotic patients

Tuberculosis in the Elderly

Outcomes of tuberculosis treatment: a retrospective cohort analysis of smoking versus non-smoking patients in Penang, Malaysia

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