Tuberculosis in ageing: high rates, complex diagnosis and poor clinical outcomes.
| Autor: | Cruz-Hervert, Luis Pablo, García-García, Lourdes, Ferreyra-Reyes, Leticia, Bobadilla-del-Valle, Miriam, Cano-Arellano, Bulmaro, Canizales-Quintero, Sergio, Ferreira-Guerrero, Elizabeth, Báez-Saldaña, Renata, Téllez-Vázquez, Norma, Nava-Mercado, Ariadna, Juárez-Sandino, Luis, Delgado-Sánchez, Guadalupe, Fuentes-Leyra, César Alejandro, Montero-Campos, Rogelio, Martínez-Gamboa, Rosa Areli, Small, Peter M., Sifuentes-Osornio, José, Ponce-de-León, Alfredo |
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| Předmět: |
TUBERCULOSIS diagnosis
TUBERCULOSIS epidemiology CHEST X rays CHI-squared test CONFIDENCE intervals CLINICAL pathology EPIDEMIOLOGY EVALUATION of medical care MORTALITY MULTIVARIATE analysis RESEARCH funding STATISTICS U-statistics LOGISTIC regression analysis DATA analysis DISEASE incidence PROPORTIONAL hazards models DATA analysis software OLD age |
| Zdroj: | Age & Ageing; Jul2012, Vol. 41 Issue 4, p488-495, 8p |
| Abstrakt: | Background: worldwide, the frequency of tuberculosis among older people almost triples that observed among young adults.Objective: to describe clinical and epidemiological consequences of pulmonary tuberculosis among older people.Methods: we screened persons with a cough lasting more than 2 weeks in Southern Mexico from March 1995 to February 2007. We collected clinical and mycobacteriological information (isolation, identification, drug-susceptibility testing and IS6110-based genotyping and spoligotyping) from individuals with bacteriologically confirmed pulmonary tuberculosis. Patients were treated in accordance with official norms and followed to ascertain treatment outcomes, retreatment, and vital status.Results: eight hundred ninety-three tuberculosis patients were older than 15 years of age; of these, 147 (16.5%) were 65 years of age or older. Individuals ≥65 years had significantly higher rates of recently transmitted and reactivated tuberculosis. Older age was associated with treatment failure (OR = 5.37; 95% CI: 1.06–27.23; P = 0.042), and death due to tuberculosis (HR = 3.52; 95% CI: 1.78–6.96; P < 0.001) adjusting for sociodemographic and clinical variables.Conclusions: community-dwelling older individuals participate in chains of transmission indicating that tuberculosis is not solely due to the reactivation of latent disease. Untimely and difficult diagnosis and a higher risk of poor outcomes even after treatment completion emphasise the need for specific strategies for this vulnerable group. [ABSTRACT FROM PUBLISHER] |
| Databáze: | Complementary Index |
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