Tuberculosis in elderly patients

Abstract

Introduction: Elderly patients are vulnerable to infectious diseases especially tuberculosis(TB). This immunodeficiency is caused by age and comorbidities. Aim of Study: Determine the prevalence of TB in elderly and compare the clinical, bacteriologic, and radiologic features of pulmonary TB in young adults and elderly patients. Methods: Retrospective study(2011-2018) including patients with pulmonary TB and treated according to WHO recommendations in pulmonary department C (Mami hospital in Tunisia). Population was divided to 2 groups (G): G1(n=42):elderly patients(age ≥65 years old), Group 2(n=418):young patients(age Results: A total of 460 patients were included(mean age 40.07+/-16.37, 61.3% were men), 60% were cigarette smoker. Elderly patients represent 9.3% of the patients. Vaccination was less frequent in G1 than G2 (68,3% vs16.7%;p 2/3of lungs in chest-X-ray) in G1(p=0.001). There was no significant difference in the prevalence of pulmonary or extra pulmonary tuberculosis between the two groups. All patients had TB treatment, 87.4% received combined treatment. Dissociated treatment was significantly more prescribed in G1 than G2 (23.8%vs11.5%; p=0.022). The delay of sputum conversion and treatment duration was similar in the 2 groups. G1 patients did not develop more side effects than G2(p>0.05). Patients of G1 had significantly more radiological sequelae (23%vs 12%; p=0.005) and higher mortality rate (12.8%vs1.7%; p=0.003) than G2. Conclusion: Morbidity and mortality caused by TB were more frequent in the older patients, periodic screening is the best prevention.