Profile and treatment outcomes of elderly patients with tuberculosis in Delhi, India: implications for their management

Patra, Somdatta; Lukhmana, Shveta; Smith, K.; Kannan, Anuradha; Satyanarayana, Srinath; Enarson, Donald A.; Nagar, Rakesh Kumar; Marcel, M.; Reid, Tirissa J.

doi:10.1093/trstmh/trt094

Cited by 32 publications

(31 citation statements)

References 14 publications

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“…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].…”

Section: Discussionsupporting

confidence: 92%

“…This agrees with a previous study [14]; but the reason(s) for this difference are not clear. It probably reflects that epidemiologic differences exist in HIV infection rates between elderly and non-elderly adults as well as its overall impact on the burden of TB between them [27].…”

Section: Discussionsupporting

confidence: 83%

“…Moreover, age-related factors have been found to enhance the susceptibility to TB infection, abetting outbreaks in institutionalized settings [12]–[13]. 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].…”

Section: Introductionmentioning

confidence: 99%

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

Oshi

Alobu³

et al. 2014

PLoS ONE

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BackgroundThe demographic transition and increasing life expectancy in Africa has lead to a rising elderly population. In Nigeria, little is known about the profile of and treatment outcomes of tuberculosis (TB) in the elderly.MethodsRetrospective cohort study of adult TB patients treated between January 2011 and December 2012 in two large health facilities in Nigeria. The demographic, clinical and treatment outcomes of patients aged 60 and older were compared with those aged 15 to 59 years.ResultsElderly (≥60 years) TB patients accounted for 12.7% of all (1668) adult TB enrolled. Elderly patients had a higher proportion of men compared to non-elderly (64.2% vs 56.8%; p = 0.043); but a lower proportion of smear-positive TB at baseline (40.7% vs 65.8%; p<0.001). A higher proportion of elderly patients failed to smear convert after the intensive phase of treatment (23.7% vs 19.8%; p = 0.06), and overall elderly patients had lower treatment success rates (68.9% vs 77.1%; p = 0.009). Unsuccessful outcomes were mainly due to higher default and deaths in the elderly. The risk factors for unsuccessful outcomes in the elderly were: extrapulmonary TB case (adjusted odds ratio (aOR) 10.9; 95% confidence interval (CI) 1.1–108), and HIV co-infection (aOR 3.6; CI 1.1–11.7).ConclusionsTreatment outcomes of elderly TB patients were inferior to non-elderly adults with higher death and default rates being implicated. With the rising elderly population, specific strategies are needed to quickly address TB management in the elderly in resource-limited settings.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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

Oshi

Alobu³

et al. 2014

PLoS ONE

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“…This suggests that possible pre-existing comorbidities, such as age-related diminishing immunity and an increased magnitude of chronic illnesses such as DM, could have exaggerated the risk for unfavourable outcomes in this group, as reported elsewhere. 21 Furthermore, the poorer outcomes may be driven by HIV, which affected nearly half of those aged 60 years. 19 In our study, adolescents had fewer adverse outcomes than the older age groups, in contradiction with a recent study from Botswana, where adverse outcomes in adolescents were more frequent than in older populations.…”

Section: Discussionmentioning

confidence: 99%

Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable?

Ncube¹,

Takarinda

Zishiri³

et al. 2017

public health action

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“…Em cerca de 5 a 10% dos casos a infecção progride imediatamente após a infecção primária (Patra et al, 2013 bovis (Finkbeiner, 1996). Apesar de ser uma doença infectocontagiosa, a difusão da TB é grandemente influenciada pelas condições econômicas e sociais da população.…”

Section: Tuberculoseunclassified

Avaliação da resistência aos tuberculostáticos de primeira linha em cepas do complexo Mycobacterium Tuberculosis isolados no Distrito Federal

Lima¹

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Dedico este trabalho aos meus filhos Maria Eduarda e Vítor e ao meu afilhado Matheus, para que desde pequenos valorizem a importância dos estudos; ao meu marido Eduardo, pelo apoio incondicional; aos meus pais, que me permitiram chegar até aqui; à minha irmã Janay,pelo incentivo e por me substituir nas minhas ausências maternas e familiares; e à minha grande amiga Pérola -quem encontrou um amigo encontrou, no meu caso, uma Pérola. AGRADECIMENTOSA Deus, pelas tantas oportunidades que me proporcionou e por ter mе dado saúde е força para superar as dificuldades.Aos meus filhos, por entenderem todas as minhas ausências, eu peço perdão.Ao meu marido, por todas as noites não dormidas e por todas as infinitas formatações e correções gramaticais, a minha eterna gratidão.Aos meus pais, pelo amor, incentivo е apoio incondicionais.À minha orientadora, Professora Dra. Janeth de Oliveira Silva Naves, pela orientação, ensinamentos e confiança depositada durante todo este projeto.À Professora e amiga Dra.

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Profile and treatment outcomes of elderly patients with tuberculosis in Delhi, India: implications for their management

Abstract: The profile and worse outcomes of elderly Indian TB patients may be indicative of co-existing NCDs. This needs further investigation and likely calls for a more comprehensive and intensive approach to their management.

Cited by 32 publications

References 14 publications

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

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

Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable?

Avaliação da resistência aos tuberculostáticos de primeira linha em cepas do complexo Mycobacterium Tuberculosis isolados no Distrito Federal

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