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Trans R Soc Trop Med Hyg. 2013 Dec;107(12):763-8. doi: 10.1093/trstmh/trt094. Epub 2013 Nov 4.

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

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  • 1Department of Community Medicine, University College of Medical Sciences and GTB Hospital, Delhi, India.

Abstract

BACKGROUND:

Given India's high rate of TB, rising burden of non-communicable diseases (NCDs) and growing elderly population, elderly TB patients may be at higher risk of adverse outcomes including death, loss-to-follow-up (LTFU) and treatment failure. This may call for modifications in their management. This study thus aimed to compare the profile and treatment outcomes between elderly (≥60 years) and non-elderly (15-59 years) TB patients.

METHODS:

This was a retrospective cohort study using routinely-collected programme data from a chest clinic in Delhi, India. It included all elderly and selected non-elderly TB patients registered for treatment between 2005 and 2010. Data on patients' clinical and demographic characteristics and treatment outcomes were analysed.

RESULTS:

There were 812 elderly and 1624 non-elderly TB patients. Elderly patients were more likely to be male (63.2% vs 51.1%) and have smear-positive TB (56.0% vs 47.4%). Adverse outcomes were more frequent among elderly patients (adjusted OR 1.9, 95% CI: 1.5-2.4), specifically deaths (adjusted OR 5.0, 95% CI: 3.1-8.1) and lost-to-follow-up (adjusted OR 1.4, 95% CI: 1.0-1.9).

CONCLUSIONS:

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.

KEYWORDS:

Elderly; India; Treatment outcomes; Tuberculosis

PMID:
24189479
[PubMed - indexed for MEDLINE]
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