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.
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 tuberculosispatients 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.
Authors: Maria De Lourdes García-García; Alfredo Ponce-De-León; Maria Cecilia García-Sancho; Leticia Ferreyra-Reyes; Manuel Palacios-Martínez; Javier Fuentes; Midori Kato-Maeda; Miriam Bobadilla; Peter Small; José Sifuentes-Osornio Journal: Emerg Infect Dis Date: 2002-11 Impact factor: 6.883
Authors: Leonardo Martinez; Alyssa Arman; Nathan Haveman; Ashley Lundgren; Lilia Cabrera; Carlton A Evans; Tom F Pelly; Mayuko Saito; David Callacondo; Richard Oberhelman; Gisela Collazo; Andrés M Carnero; Robert H Gilman Journal: Am J Trop Med Hyg Date: 2013-07-22 Impact factor: 2.345
Authors: Juan I Moliva; Murugesan V S Rajaram; Sabeen Sidiki; Smitha J Sasindran; Evelyn Guirado; Xueliang Jeff Pan; Shu-Hua Wang; Patrick Ross; William P Lafuse; Larry S Schlesinger; Joanne Turner; Jordi B Torrelles Journal: Age (Dordr) Date: 2014-03-03