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

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

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use*
  • Cohort Studies
  • Female
  • Health Services Accessibility*
  • Humans
  • India / epidemiology
  • Male
  • Mass Screening
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Treatment Outcome
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology*
  • Young Adult

Substances

  • Antitubercular Agents