Tuberculosis in the Elderly (Aged 50 Years and Above) and Their Treatment Outcome Under Dots

Chand, Nirmal; Bhushan, Bharat; Singh, Daljit; Pandhi, Naveen; Thakur, Seema; Bhullar, Swarnjeet S.; Arora, Mandeep; Khalsa, J.S.; Singh, K.K.; Rathor, Navneeta; Gupta, Sandeep

doi:10.1378/chest.132.4_meetingabstracts.640b

Cited by 8 publications

(7 citation statements)

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“…We found also that there were insignificant differences between age of patients and HB level and WBC (p-value 0.823, 0.077 respectively). Chand et al and Lee et al also reported that complete blood counts showed no significant differences between mean leukocyte counts or the incidences of leukocytosis and this result was in agreement with our results [10,38]. On the other hand, Rawat et al reported that anemia and hypoalbuminemia were considerably more prevalent in older patients.…”

Section: Discussionsupporting

confidence: 92%

Pattern of Tuberculosis in Elderly Patients in Egypt

Ghweil¹,

Alsenbsy²,

Badawy³

et al. 2018

J Trop Dis

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Background and study aim: Tuberculosis (TB) is one of the most prevalent and grave of all humanoid contagious diseases and is still a major infectious disease worldwide. The geriatric population in developed countries represents a big reservoir of tuberculosis infection across all racial and sex subsets. We aim in this study to assess the pattern of TB in elderly patients in Qena governorate in Egypt. Patients and methods: All patients aged 50 years and above who were diagnosed with TB have been included in the study. The patients were evaluated regarding the incidence rate: for new cases, and relapse cases (pulmonary and extra pulmonary). Results: The mean age of included patients was 41.18 years and 51.3% of the studied patients were male. Regarding residence we found 54.7% of patients live in rural areas and 45.3% in urban. 82.9% of the patients were tuberculin positive. As regard chest x-ray finding we found: normal in 17.1% of patients, 17.1% bilateral, 25.6% right upper lobe 16.2% whole right lung, 10.3% left upper lobe, 6% left lower lobe, 3.4% right lower lobe, 2.6% pleural effusion and 1.7% whole left lung. In the present study we found that 81.2% of patients had pulmonary TB and 18.8% had extra pulmonary TB. Conclusion: The study documents important variances in clinical and radiological findings of pulmonary TB in geriatric patients. Sputum analysis for AFB remains a significant, easy and cheap method for diagnosis, but might not be continuously supportive in early diagnosis.

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Section: Discussionsupporting

confidence: 92%

Pattern of Tuberculosis in Elderly Patients in Egypt

Ghweil¹,

Alsenbsy²,

Badawy³

et al. 2018

J Trop Dis

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“…Higher TB‐related mortality (1.3% vs 11.1%, P < 0.05) was noted in the elderly in Korea 124 . A recent Indian study showed mortality rates of 12.5% in the ≥65‐year age group as compared with 5.5% in 50‐ to 65‐year age group 103 …”

Section: Tuberculosis In the Elderlymentioning

confidence: 93%

“…In Europe, a rise in the mean age of the population is expected from 34.9 years in 2004 to 44.4 years in 2024 102 . In India, an increase in life expectancy and the resultant increase in the older population (≥50 years old) has led to an increase in the number of TB cases in this age group 103 . On the other hand, life expectancy in sub‐Saharan African countries has significantly declined due to HIV/AIDS and its related opportunistic infections, in particular TB.…”

Section: Tuberculosis In the Elderlymentioning

confidence: 99%

Tuberculosis at extremes of age

Schaaf¹,

Collins²,

Bekker³

et al. 2010

Respirology

136

125

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Although tuberculosis (TB) has its highest burden among young adults, especially since the advent of HIV infection, two other groups with low immunity, the very young (<1 year) with immature immunity and the elderly (>65 years) with waning immunity, are vulnerable groups not to be forgotten. This review describes the epidemiology,clinical aspects,public health aspects and outcome of TB in patients at the extremes of age. The epidemiology differs therein that TB in infants occurs in developing countries with high incidences of TB and HIV, while TB in the elderly occurs in developed countries with ageing populations. The clinical presentation may be non-specific, history of contact with TB is often not known and TB is often not considered at these age extremes, and when the diagnosis is considered, disease progression may already be advanced. Anti-TB treatment regimens are the same as in other age groups, but drug dosages may need adjustment according to weight, renal function, liver function and other potentially complicating factors. Adverse events are more difficult to observe and both the young and the elderly are reliant on others for adherence to treatment. Mortality at both age extremes is higher than in the general TB population. For all the above reasons, public health measures to: prevent transmission of infection; identify those infected and providing preventive therapy; high index of suspicion in order to make an early diagnosis; and timely initiation of treatment are important in both the very young and the elderly.

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“…In elderly patients, many clinical features of TB are subtle or absent, making diagnosis difficult. Autopsy among the elderly suggests that TB often remains unrecognized [103,104]. This population group is also at greater risk for re-activation of LTBI and for acquisition of new TB infection.…”

Section: Tb In Elderly Populationmentioning

confidence: 99%

“…Furthermore, the elderly also present challenging to receive treatment due to adverse effects (i.e. hepatoxicity), and the poor outcome of treated TB in this age group warrants more aggressive treatment [103,104]. Therefore, it is not surprising that compared with younger individuals, the mortality rate of TB in elders is six times higher [103,104].…”

Section: Tb In Elderly Populationmentioning

confidence: 99%

Tuberculosis (TB) and Human Rights in Chiapas, Mexico

Sánchez-Pérez¹,

Gómez‐Velasco²,

Leal³

et al. 2015

Tuberculosis - Expanding Knowledge

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following topics: human rights, the right to health, principles of health rights, patient rights, TB in several vulnerable populations (children, elderly, women, indigenous groups and migrants); and legal health reforms in Mexico and its impact in DOTS strategy. 2. Chiapas: A brief description of epidemiological TB situation In Mexico, in 2013 there were registered 21,381 cases of TB (in all its forms) with a incidence rate of 16.7 per 100,000 inhabitants [12], from which 92.3% were new cases; 81.7% were PTB; 21% were associated with DM and 5.6% with HIV/AIDS; 1.05% were drug-resistant (any forms) and 8.4% were pediatric [12]. Among the pediatric group, 68.2% were PTB and 31.8% extrapulmonary-TB [12]. Chiapas, Guerrero, Veracruz, Puebla, and Tabasco, are Mexican states which contribute every year about 5,400 new cases of PTB, and this constitutes 36% of the total national average [12]. Factors that contribute to the high prevalence of PTB in these states are: (a) internal and external migration; (b) problems with accessibility to health services and social security; (c) significant presence of indigenous populations; (d) more than 90% of their municipalities are considered with low human development index [13,14]; (e) inadequate implementation of the DOTS strategy [10]; (f) little or null access to early TB diagnosis [10]. The above-mentioned factors, related to life styles and living conditions also contribute to health inequities increasing the high prevalence of TB in Chiapas and worldwide. According to official data provided by the Mexican Ministry of Health, in 2012, Baja California, Guerrero and Tamaulipas, were states with the highest incidence rates of TB, all its forms, (54.8, 38.1 and 32.0, respectively, per 100,000 inhabitants), while Chiapas ranked eleventh place with an incidence rate of 24.4 per 100,000 in the same denominator [15]. On the other hand, Tlaxcala and the State of Mexico were ranked with the lowest incidence rates, 3.9 and 4.4 per 100,000, respectively [15]. Regarding to PTB, for the same year, the registered incidence rate for the whole country was 13.6 per 100,000 inhabitants, whereas Chiapas ranked eighth with 21.8 incidence rate for the same denominator [15]. For administrative purposes, Chiapas is divided into ten health districts or sanitary jurisdictions. For 2012, the three regions with highest registered incidence rates were Tapachula, Tonala and Pichucalco, having 59.3, 33.1 and 22.3 per 100,000 inhabitants, respectively, while San Cristobal and Comitan regions reported the lowest incidence rate with 11.7 and 12.7 per 100,000 people, respectively [16]. However, epidemiological studies carried out in the San Cristobal region 1 , also known as the Highlands region, have reported high morbidity and mortality rates which doubles the state and national figures [9,10,17-25]. Furthermore, the official epidemiological data is based on notified cases by the health sector systems, and this could lead to under-quantification of cases in great part due to under-diagnosis. In Chiapas, the ...

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Tuberculosis in the Elderly (Aged 50 Years and Above) and Their Treatment Outcome Under Dots

Cited by 8 publications

References 0 publications

Pattern of Tuberculosis in Elderly Patients in Egypt

Pattern of Tuberculosis in Elderly Patients in Egypt

Tuberculosis at extremes of age

Tuberculosis (TB) and Human Rights in Chiapas, Mexico

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