Bridging the Gap in End Tuberculosis Targets in the Elderly Population in Eastern China: Observational Study From 2015 to 2020

Abstract

Background With a progressive increase in the aging process, the challenges posed by pulmonary tuberculosis (PTB) are also increasing for the elderly population. Objective This study aimed to identify the epidemiological distribution of PTB among the elderly, forecast the achievement of the World Health Organization’s 2025 goal in this specific group, and predict further advancement of PTB in the eastern area of China. Methods All notified active PTB cases aged ≥65 years from Zhejiang Province were screened and analyzed. The general epidemiological characteristics were depicted and presented using the ArcGIS software. Further prediction of PTB was performed using R and SPSS software programs. Results Altogether 41,431 cases aged ≥65 years were identified by the surveillance system from 2015 to 2020. After excluding extrapulmonary TB cases, we identified 39,832 PTB cases, including laboratory-confirmed (23,664, 59.41%) and clinically diagnosed (16,168, 40.59%) PTB. The notified PTB incidence indicated an evident downward trend with a reduction of 30%; however, the incidence of bacteriologically positive cases was steady at approximately 60/100,000. Based on the geographical distribution, Quzhou and Jinhua Cities had a higher PTB incidence among the elderly. The delay in PTB diagnosis was identified, and a significantly prolonged treatment course was observed in the elderly. Moreover, a 50% reduction of PTB incidence by the middle of 2024 was predicted using a linear regression model. It was found that using the exponential smoothing model would be better to predict the PTB trend in the elderly than a seasonal autoregressive integrated moving average model. Conclusions More comprehensive and effective interventions such as active PTB screening combined with physical checkup and succinct health education should be implemented and strengthened in the elderly. A more systematic assessment of the PTB epidemic trend in the elderly population should be considered to incorporate more predictive factors.

The effect of diabetes mellitus on tuberculosis in eastern China: A decision‐tree analysis based on a real‐world study

“…Notably, the proportion of DM among male patients with PTB was significantly higher than that among female patients (78.85% vs. 21.15%), which is similar to the results of other research reports 23,24 . This phenomenon may be related to the fact that DM itself is more prevalent in men.…”

“…Notably, the proportion of DM among male patients with PTB was significantly higher than that among female patients (78.85% vs. 21.15%), which is similar to the results of other research reports. 23,24 This phenomenon may be related to the fact that DM itself is more prevalent in men. Differences in energy balance, metabolic regulation, and lifestyle make men more likely to develop obesity, insulin resistance, and hyperglycemia.…”

Spatial–temporal analysis of pulmonary tuberculosis among students in the Zhejiang Province of China from 2007–2020

“…Completion of treatment course was defined as: (1) clinically diagnosed PTB patients completed the standardized course and had negative sputum smear/culture results and (2) laboratory-confirmed patients who completed the prescribed course of treatment, with a negative sputum test result at the latest, and no sputum test result at the end of the course of treatment. Cure was defined as persistent negative sputum smear or culture results for two times, one of which was at the completion of the standardized course of treatment in laboratory-confirmed patients ( 20 ). Multidrug-resistant tuberculosis (MDR-TB) was defined as tuberculosis that was resistant to two or more drugs, such as isoniazid and rifampin ( 21 ).…”

Assessment of Effective Anti-TB Regimens and Adverse Outcomes Related Risk Factors in the Elderly and Senile-Aged TB Patients

“…The results of our study revealed that the treatment success rate of 1191 senile-aged patients with TB was 84.80% (1010/ 1191), which was higher than that reported in Zhejiang Province between 2015 and 2020 (71.19%). 15 Among them, 601 cases were cured, accounting for 50.46%; 409 cases completed the course of treatment, accounting for 34.34%; 11 cases failed treatment, accounting for 0.92%; 94 cases were lost to follow-up, accounting for 7.89%; and 76 cases died, accounting for 6.38%. Compared to younger patients with TB, senile-aged patients with TB had a higher incidence of adverse outcomes particularly in terms of lost to follow-up and deaths.…”