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Introduction: In low-incidence countries the geriatric population represents the largest reservoir of TB infection. In 2014 the annual incidence of TB in Portugal decreased to 20/100000 - threshold of low incidence countries. Aim: We aimed to understand the epidemiological changes in the clinical profiles of TB patients concurrent with this decrease in incidence. Methods: Data from the Regional TB Registry (Amadora region) was used to perform a retrospective analysis for the years 2000 and 2014. We included two groups of patients – a younger group (15-44 year-old) and an elderly group (≥65 year-old). Results: There was a total of 207 and 193 TB cases in 2000 and 2014, respectively. The proportion of TB among the elderly varied from 10% in 2000 to 16% in 2014. Comparing 2000 to 2014, we noted an increase in the proportion of non-native citizens among the younger (26% to 41%) but a decrease in the elderly (20% to 13%). Pulmonary presentation proportion decreased from 2000 to 2014 (79% to 71%, younger group; 65% to 45%, elderly group). In 2000, comorbidities were more frequent in the younger group (62% vs 55%) due to HIV and intravenous drug abuse (IDA), whereas in 2014 were more frequent in the elderly group (36% vs 58%) due to chronic diseases such as kidney disease and diabetes. Treatment success rate was higher among the elderly in 2000 (88% vs 100%) but lower in that age group in 2014 (89% vs 78%). Conclusions: The decrease in TB incidence was accompanied by an increase of TB among the elderly, consistent with a shift from a high incidence epidemiological pattern to a low incidence one. We also noted a shift in the prevalence of comorbidities between the groups due to a decrease in prevalence of HIV and IDA in our population. |
