Factors associated with tuberculosis treatment outcomes among patients aged ≥60 years
Tuberculosis (TB) is emerging as a significant health problem among the elderly. Patients with pulmonary tuberculosis (PTB) of advanced age were less likely to achieve treatment success and the proportion of death showed a substantial increase with age. This study aimed to determine the association between factors and treatment outcomes among patients aged ≥60 years. A retrospective cohort study was conducted. A total of 8,359 elderly PTB patient records were extracted from the TBCM databases (TB Case Management) of the Bureau of Tuberculosis, Department of Disease Control. The study group comprised all new smear-positive PTB patients aged 60 years and above registered for treatment between 1 October 2015 and 30 September 2016. The overall treatment success rates were 77.60% and mortality rate were 16% among PTB patients aged ≥60 years. Patient’s age, sex, and HIV status were associated with treatment success among patients aged ≥60 years with PTB. The high treatment success rates were shown among patients aged 60 to 69 years (83.60%), among female elderly PTB patients (80.30%), and among elderly PTB patients with HIV negative (79.80%). Patient’s age, sex, grading of AFB, and HIV status were associated with death during TB treatment among PTB patients aged 60 years and above. The high mortality rates were reported among patients aged ≥80 years (33.80%), among male elderly PTB patients (16.80%), among PTB patients had smear 3+ positive results (17.40%), and among elderly PTB patients had positive anti-HIV test results (33.30%). Elderly TB patients undergoing treatment with anti-TB drugs should be closely monitored and should complete TB treatment course as these will result in an increased TB treatment success rate.
2. Bureau of Tuberculosis, Department of Disease Control, Ministry of Public Health, Thailand. Data from the TB 07 report [Internet]. 2016 [cited 2017 May 20 and Dec 11]. Available from: http://tbcmthailand.ddc.moph.go.th/uiform/dashboardtb.aspx
3. Rita Sood. The problem of geriatic tuberculosis. J Indian Acad Clin Med 2005;5:156-62.
4. Mackoy AD, Cole RB. The problems of tuberculosis in the elderly. QJ Med 1984;53:497-510.
5. Nirmal Chand, Bharat Bhushan, Daljit Singh, Naveen Pandhi, Somesh Thakur, Swarnjeet S, et al. Tuberculosis in the elderly (aged 50 years and above) and their treatment outcome under DOTS. Chest J 2007;132:640B.
6. Mukherjee A, Saha I, Paul B. Tuberculosis in patients below and above 60 years and their treatment outcome under RNTCP - a study in rural West Bengal, India. J Indian Acad Geriatr 2008;4:60-3.
7. Leung CC, Yew WW, Chan CK, Chau CH, Tam CM, Lam CW, et al. Tuberculosis in older people: a retrospective and comparative study from Hong Kong. J Am Geriatr Soc 2002;50:1219-26.
8. Anunnatsiri S, Chetchotisakd P, Wanke C. Factors associated with treatment outcome in pulmonary tuberculosis in Northeastern Thailand. Southeast Asian J Trop Med Public Health 2005;36:324-30.
9. Department of Disease Control, Ministry of Public Health, Thailand. Report of tuberculosis program performance in Thailand, 2009-2015. Bangkok: Bureau of Tuberculosis; 2016.
10. World Health Organization. Definitions and reporting framework for tuberculosis-2013 revision (updated December 2014). Geneva: World Health Organization; 2014.
11. Didilescu C, Tigău M, Dediu I, Stoicescu I. Clinical and epidemiological aspects of TB cases registered in persons aged > or = 65 between 2002-2006, at the TB dispensary of sector 4, Bucharest. Pneumologia 2008;57:148-54.
12. Research Institute of Tuberculosis, JATA. Tuberculosis annual report 2009--Series 4. Elderly TB. Kekkaku 2011;86:737-41.
13. Salvadó M, Garcia-Vidal C, Vázquez P, Riera M, Rodriguez-Carballeira M, Martínez-Lacasa J, et al. Mortality of tuberculosis in very old people. J Am Geriatr Soc 2010;58:18-22.
14. Bao QS, Du YH, Lu CY. Treatment outcome of new pulmonary tuberculosis in Guangzhou, China 1993-2002: a register-based cohort study. BMC Public Health 2007;7:344.
15. Farah MG, Tverdal A, Steen TW Steen, Heldal E, Brantsaeter AB, Bjune G. Treatment outcome of new culture positive pulmonary tuberculosis in Norway. BMC Public Health, 2005;5:14.
16. Falzon D, Le Strat Y, Belghiti F, Infuso A. Exploring the determinants of treatment success for tuberculosis cases in Europe. Int J Tuberc Lung Dis 2005;9:1224-9.
17. Wobeser W, Yuan L, Naus M. Outcome of pulmonary tuberculosis treatment in the tertiary care setting--Toronto 1992/93. Tuberculosis Treatment Completion Study Group. CMAJ 1999;160:789-94.
18. Pablos-Mendez A, Knirsch CA, Barr RG, Lerner BH, Frieden TR. Nonadherence in tuberculosis treatment: predictors and consequences in New York City. Am J Med 1997;102:164-70.
19. Tansuphasawadikul S, Poprawski DM, Pitisuttithum P, Phonrat B. Nonadherence in tuberculosis treatment among HIV patients attending Bamrasnaradura Hospital, Nonthaburi. J Med Assoc Thai 1998;81:964-9.
20. Shen X, Deriemer K, Yuan Z, Shen M, Xia Z, Gui X, et al. Deaths among tuberculosis cases in Shanghai, China: who is at risk?. BMC Infect Dis 2009;9:95.
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