Tuberculosis in older adults in Soweto, South Africa

As, Karstaedt; Bolhaar, M

doi:10.5588/ijtld.14.0210

Cited by 12 publications

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“…[8] Older adults are more likely to experience comorbidities, drug-related adverse events, atypical forms of disease and extrapulmonary tuberculosis, which complicate diagnosis and treatment. [10] Although studies of TB among the elderly are limited in SA, data from Soweto confirm the very high rates of extrapulmonary TB (50%) and predisposing diseases (46%) in TB patients aged ≥65 years, [12] suggesting that older adults may pose a growing challenge to TB control in the future. SA's HIV epidemic is also ageing, with the prevalence of HIV in people aged ≥50 years expected to double in the next 30 years.…”

Section: Discussionmentioning

confidence: 82%

Outcomes of treatment of drug-susceptible tuberculosis at public sector primary healthcare clinics in Johannesburg, South Africa: A retrospective cohort study

et al. 2016

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Background.Despite the large number of tuberculosis (TB) patients treated in South Africa (SA), there are few descriptions in the published literature of drug-susceptible TB patient characteristics, mode of diagnosis or treatment outcomes in routine public sector treatment programmes. Objective. To enhance the evidence base for public sector TB treatment service delivery, we reported the characteristics of and outcomes for a retrospective cohort of adult TB patients at public sector clinics in the Johannesburg Metropolitan Municipality (JHB), SA. Methods. We collected medical record data for a retrospective cohort of adult (≥18 years) TB patients registered between 1 April 2011 and 31 March 2012 at three public sector clinics in JHB. Data were abstracted from National TB Programme clinic cards and the TB case registers routinely maintained at study sites. We report patient characteristics, mode of diagnosis, mode of treatment supervision, treatment characteristics, HIV status and treatment outcomes for this cohort. Results. A total of 544 patients were enrolled in the cohort. Most (86%) were new TB cases, 81% had pulmonary TB, 58% were smearpositive at treatment initiation and 71% were HIV co-infected. Among 495 patients with treatment outcomes reported, 80% (n=394) had successful outcomes, 11% (n=55) were lost to follow-up, 8% (n=40) died and 1% (n=6) failed treatment. Conclusions. Primary healthcare clinics in JHB are achieving relatively high rates of success in treating drug-susceptible TB. Missing laboratory results were common, including follow-up smears, cultures and drug susceptibility tests, making it difficult to assess adherence to guidelines and leaving scope for substantial improvements in record-keeping at the clinics involved.

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Section: Discussionmentioning

confidence: 82%

Outcomes of treatment of drug-susceptible tuberculosis at public sector primary healthcare clinics in Johannesburg, South Africa: A retrospective cohort study

et al. 2016

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“…Few studies exist on the TB burden among older adults in Southern Africa. Karstaedt and Bolhaar found a high burden of TB among the elderly in Soweto and that 50% of the older adults with TB had extra-pulmonary tuberculosis [ 17 ]. Blaser and colleagues’ age-structured transmission model for Cape Town found that simulated TB notification rates gradually increased from the age of 30 years [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis among older adults in Zambia: burden and characteristics among a neglected group

et al. 2017

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BackgroundThe 2010 Global Burden of Disease estimates show that 57% of all TB deaths globally occurred among adults older than 50 years of age. Few studies document the TB burden among older adults in Southern Africa. We focused on adults older than 55 years to assess the relative TB burden and associated demographic factors.MethodsA cross sectional nationally representative TB prevalence survey conducted of Zambian residents aged 15 years and above from 66 clusters across all the 10 provinces of Zambia. Evaluation included testing for TB as well as an in-depth questionnaire. We compared survey data for those aged 55 and older to those aged 15–54 years. Survey results were also compared with 2013 routinely collected programmatic notification data to generate future hypotheses regarding active and passive case finding.ResultsAmong older adults with TB, 30/ 54 (55.6%) were male, 3/27 (11.1%) were HIV infected and 35/54 (64.8%) lived in rural areas. TB prevalence was higher in those aged ≥55 (0.7%) than in the 15–54 age group (0.5%). Males had higher rates of TB across both age groups with 0.7% (15–54) and 1.0% (≥55) compared with females 0.4% (15–54) and 0.6% (≥55). In rural areas, the prevalence of TB was significantly higher among older than younger adults (0.7% vs 0.3%), while the HIV infection rate was among TB patients was lower (11.1% vs 30.8%). The prevalence survey detected TB in 54/7484 (0.7%) of older adults compared to 3619/723,000 (0.5%) reported in 2013 programmatic data.ConclusionHigh TB rates among older adults in TB endemic areas justify consideration of active TB case finding and prevention strategies.

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“…However in Senegal, few studies focused on the association between HIV infection and Extrapulmonary Tuberculosis [19,25]. Otherwise, this association is almost common in Zambia [14], Ethiopia [21], South Africa [32] and Burkina Faso [33] in the African continent where HIV infection is very frequent. In Europe, the same risk was observed in Portugal [24], France [34] and Spain [35].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Extra Pulmonary Tuberculosis in the Health District of Thies, Senegal

Touré¹

2017

CAJPH

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Tuberculosis (TB) is a national health priority in African countries particularly pulmonary form. But Extrapulmonary TB (EPTB) is increasing with less consideration for the governments. However, it has a negative impact in the social, economic and sanitary context. Few studies on the disease have been conducted in the African continent. The objective of this study was to estimate the incidence of Extrapulmonary TB in the Health District of Thies, a Senegalese province. Through a retrospective study, we collected data of all cases of TB admitted at the TB Division of the Health District of Thies, Senegal from January 2012 to December 2014. Sociodemographic characteristics of the patients, past medical history, lifestyles, the type of TB (pulmonary or extrapulmonary), the treatment regimen and the prognosis was evaluated. Uni, bi and multivariate analysis were done and results expressed with a 95% confidence interval. On average, 824 patients with TB were included. They were mostly male (68.4%), jobless (62.9%), not married (58.9%) with a mean age of 33.3 years (±14.3). They had in their past medical history a notion of TB contamination (30.1%), BCG vaccination (96.5%), hypertension (4.6%), diabetes (2.7%), HIV infection (1.7%), smoking (11.5%) and alcohol consumption (2.8%). Hundred and Five patients (12.7% with CI 95%: 10.7% -14.7%) had EPTB of pleural (56.2%), lymphatic (12.4%), bone (9.5%) and gastrointestinal (9.5%) localization mainly. Age, notion of contact with patient, employment and HIV infection were associated independently to EPTB. It is important de take into consideration these results to strengthen primary prevention strategies.

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Tuberculosis in older adults in Soweto, South Africa

Cited by 12 publications

References 0 publications

Outcomes of treatment of drug-susceptible tuberculosis at public sector primary healthcare clinics in Johannesburg, South Africa: A retrospective cohort study

Outcomes of treatment of drug-susceptible tuberculosis at public sector primary healthcare clinics in Johannesburg, South Africa: A retrospective cohort study

Tuberculosis among older adults in Zambia: burden and characteristics among a neglected group

Risk Factors for Extra Pulmonary Tuberculosis in the Health District of Thies, Senegal

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