Manifestations of tuberculosis in elderly versus young hospitalised patients in Amritsar, India

Bhushan, Bharat; Kajal, Nirmal Chand; Maske, A; Singh, S P

doi:10.5588/ijtld.11.0778

Cited by 20 publications

(15 citation statements)

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“…A higher proportion of elderly males (46%vs 37%) were smokers in this study. A study from Amritsar among hospitalised TB patients showed no difference in smoking between the elderly and younger [10] while a descriptive study in a cohort of 100 patients aged >50 yrs from Himachal Pradesh documented 68% smoking [11]. Smoking cessation interventions focusing on the elderly will be important to reduce the burden of complications due to TB.…”

Section: Discussionmentioning

confidence: 99%

Profile and Response to Anti-Tuberculosis Treatment among Elderly Tuberculosis Patients Treated under the TB Control Programme in South India

et al. 2014

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IntroductionThe demographic transition in India has resulted in an increase in the elderly population. There is limited data on the profile of elderly tuberculosis (TB) patients and their treatment outcomes in India.ObjectiveTo compare the clinical profile, presentation and response to anti-TB treatment among elderly (≥60 yrs) and younger (15–59 yrs) TB patients treated under the Revised National TB Control programme.MethodologyRetrospective cohort analysis of TB patients treated from May 1999 to December 2004 in one Tuberculosis Unit of Tiruvallur district, South India.ResultsRecords of 865 elderly and 4343 younger TB patients were examined: elderly were more likely to be male (84% vs. 71%), smokers (46% vs.37%), illiterate (63% vs. 45%), identified by active case finding through survey (19% vs. 11%), have pulmonary TB (96% vs. 91%) and initial smear negative disease (46% vs. 36%) compared to younger (for all p<0.001). Among a total of 352 elderly and 1933 younger new smear positive pulmonary TB, the elderly had higher loss to follow-up (15% vs. 11%; p = 0.03) and death rates (9% vs. 4%; p<0.001). Mycobacterium tuberculosis susceptibility to first line anti-TB drugs did not differ (elderly 87% vs. younger 84%) (p = 0.20). Side effects related to anti-TB drugs were reported by a higher proportion of elderly patients (63% vs. 54%) (p = 0.005). Previously treated patients had similar treatment outcomes in both the groups.ConclusionElderly TB patients are less likely to have smear positive disease. Newly diagnosed elderly TB patients are more likely to be lost to follow-up or die and report drug side effects. Suitable interventions need to be developed for effective management and better treatment outcomes of TB in the elderly.

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Section: Discussionmentioning

confidence: 99%

Profile and Response to Anti-Tuberculosis Treatment among Elderly Tuberculosis Patients Treated under the TB Control Programme in South India

et al. 2014

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“…Persistence of TB in this age group may become an important source of infection and perpetuate the pool of infection in the community. Though previous studies in India between 1996 and 2005 have described poor treatment outcomes in this age group, these were conducted either in a tertiary care setting or were limited to a small geographical area [3], [5], [13]–[15]. Association of important factors including the type of TB, HIV status, type of DOT (Directly Observed Treatment) provider (a health care provider administering treatment and providing patient support) have not been studied in great detail in older TB patients.…”

Section: Introductionmentioning

confidence: 99%

The Profile and Treatment Outcomes of the Older (Aged 60 Years and Above) Tuberculosis Patients in Tamilnadu, South India

Ananthakrishnan¹,

Kumar²,

Ganesh³

et al. 2013

PLoS ONE

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BackgroundWith changing demographic patterns in the context of a high tuberculosis (TB) burden country, like India, there is very little information on the clinical and demographic factors associated with poor treatment outcome in the sub-group of older TB patients. The study aimed to assess the proportion of older TB patients (60 years of age and more), to compare the type of TB and treatment outcomes between older TB patients and other TB patients (less than 60 years of age) and to describe the demographic and clinical characteristics of older TB patients and assess any associations with TB treatment outcomes.MethodsA retrospective cohort study involving a review of records from April to June 2011 in the 12 selected districts of Tamilnadu, India. Demographic, clinical and WHO defined disease classifications and treatment outcomes of all TB patients aged 60 years and above were extracted from TB registers maintained routinely by Revised National TB Control Program (RNTCP).ResultsOlder TB patients accounted for 14% of all TB patients, of whom 47% were new sputum positive. They had 38% higher risk of unfavourable treatment outcomes as compared to all other TB patients (Relative risk (RR)-1.4, 95% CI 1.2–1.6). Among older TB patients, the risk for unfavourable treatment outcomes was higher for those aged 70 years and more (RR 1.5, 95% CI 1.2–1.9), males (RR 1.5, 95% CI 1.0–2.1), re-treatment patients (RR 2.5, 95% CI 1.9–3.2) and those who received community-based Direct Observed Treatment (RR 1.4, 95% CI 1.1–1.9).ConclusionTreatment outcomes were poor in older TB patients warranting special attention to this group – including routine assessment and recording of co-morbidities, a dedicated recording, reporting and monitoring of outcomes for this age-group and collaboration with National programme of non-communicable diseases for comprehensive management of co-morbidities.

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“…3 TB may present and manifest itself differently in older compared with younger adults. 4 Furthermore, older adults are at high risk of non-communicable diseases, especially diabetes mellitus. It is well established that the risk of TB among people with diabetes increases by two-to three-fold, 5 with those who later develop TB having poorer treatment outcomes.…”

Section: Tuberculosis Case Burden and Treatment Outcomes In Childrenmentioning

confidence: 99%

“…Tagaro, 1 A. D. Harries, 2,3 B. Kool, 4 S. Ram, 5 K. Viney, 6 B. Marais, 7 L. Tarivonda 8 V anuatu is an island country located in the South Pacific. The National Tuberculosis Programme (NTP) was started in Vanuatu in the early 1980s, and the DOTS strategy 1 was introduced in 1999.…”

Section: Tuberculosis Case Burden and Treatment Outcomes In Childrenmentioning

confidence: 99%

Tuberculosis case burden and treatment outcomes in children, adults and older adults, Vanuatu, 2007–2011

Tagaro

Harries

Kool

et al. 2014

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Manifestations of tuberculosis in elderly versus young hospitalised patients in Amritsar, India

Abstract: The presentation of TB in elderly patients differs from that of younger patients in symptomatology. A high index of suspicion is therefore required to make a timely diagnosis of TB in the elderly.

Cited by 20 publications

References 0 publications

Profile and Response to Anti-Tuberculosis Treatment among Elderly Tuberculosis Patients Treated under the TB Control Programme in South India

Profile and Response to Anti-Tuberculosis Treatment among Elderly Tuberculosis Patients Treated under the TB Control Programme in South India

The Profile and Treatment Outcomes of the Older (Aged 60 Years and Above) Tuberculosis Patients in Tamilnadu, South India

Tuberculosis case burden and treatment outcomes in children, adults and older adults, Vanuatu, 2007–2011

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