Tuberculosis In Elderly Patients Research Articles

Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia: A retrospective cohort study.

Smear-positive pulmonary tuberculosis (SPPTB) is the major contributor to the spread of tuberculosis (TB) infection, and it creates high morbidity and mortality worldwide. The objective of this study was to determine the predictors of delayed sputum smear conversion at the end of the intensive phase of TB treatment in Kota Kinabalu, Malaysia.This retrospective study was conducted utilising data of SPPTB patients treated in 5 TB treatment centres located in Kota Kinabalu, Malaysia from 2013 to 2018. Pulmonary TB (PTB) patients included in the study were those who had at least completed the intensive phase of anti-TB treatment with sputum smear results at the end of the 2nd month of treatment. The factors associated with delayed sputum smear conversion were analyzed using multiple logistic regression analysis. Predictors of sputum smear conversion at the end of intensive phase were evaluated.A total of 2641 patients from the 2013 to 2018 periods were included in this study. One hundred eighty nine (7.2%) patients were identified as having delayed sputum smear conversion at the end of the intensive phase treatment. Factors of moderate (advanced odd ratio [aOR]: 1.7) and advanced (aOR: 2.7) chest X-ray findings at diagnosis, age range of >60 (aOR: 2.1), year of enrolment 2016 (aOR: 2.8), 2017 (aOR: 3.9), and 2018 (aOR: 2.8), smokers (aOR: 1.5), no directly observed treatment short-course (DOTS) supervisor (aOR: 6.9), non-Malaysian citizens (aOR: 1.5), and suburban home locations (aOR: 1.6) were associated with delayed sputum smear conversion at the end of the intensive phase of the treatment.To improve sputum smear conversion success rate, the early detection of PTB cases has to be fine-tuned so as to reduce late or severe case presentation during diagnosis. Efforts must also be in place to encourage PTB patients to quit smoking. The percentage of patients assigned with DOTS supervisors should be increased while at the same time ensuring that vulnerable groups such as those residing in suburban localities, the elderly and migrant TB patients are provided with proper follow-up treatment and management.

CLINICO-RADIOLOGICAL PATTERN OF PULMONARY TUBERCULOSIS AMONG ELDERLY AND YOUNG ADULTS IN A TERTIARY CARE CENTER.

Background: Clinical and radiographic manifestation of tuberculosis in elderly patients varies from young adults and not specic, often mistaken with other disease which may cause delay of therapy. For this we conducted study on clinical and radiographic manifestation of pulmonary tuberculosis in elderly patients. This study Methods: analyzed 100 pulmonary tuberculosis cases. We divided these patients in 2 groups i.e young adults (aged <60 years) and elderly(aged ≥60 years). This study was conducted in the Department of TB & Respiratory Diseases, RNT Medical College, Udaipur and analyzed by using Microsoft excel. We found that this study is Result: dominated by male patients. Chest pain, cough, dyspnoea, hemoptysis were found in-signicantly, while expectoration was found signicantly higher in young adults (p < 0.01). Fever was more in young whereas anorexia was more common in elderly group and in physical signs, icterus was found signicantly more in young adults as the p value is <0.05. Radiological bilateral involvement was found more in elderly group compared to adults (p = 0.67). Mixed and upper zone in adult patients consist majority patients. Elderly patients of PTB presented Conclusion: with recognized clinical and radiological features of disease.

Primary Drug-Resistance Pattern and Trend in Elderly Tuberculosis Patients in Shandong, China, from 2004 to 2019.

BackgroundWith an aging population, China is facing a huge burden of elderly patients with drug resistant tuberculosis (DR-TB), which has become a significant obstacle for the global TB control. There is still little study on DR-TB in the elderly in China so far. Thus, more research on the epidemiological characteristics and trend of primary DR-TB among the elderly will be necessary.MethodsA retrospective study was conducted in Shandong, China from 2004 to 2019. We collected 12,661 primary TB cases, of which 4368 elderly (≥60 years) primary TB cases were involved. Clinical characteristics including age, sex, cavity, smoking, drinking, comorbidity and drug susceptibility data were collected from 36 TB prevention and control institutions of Shandong Province. Sputum samples were collected by each surveillance site, and examined in the TB Reference Laboratory of SPCH. Descriptive statistical analysis, chi-square and linear regression were used for analyzing.ResultsAmong 4368 elderly patients with primary TB, the DR-TB and multi-resistant tuberculosis (MDR-TB) accounted for 17.19% and 2.29%, respectively. During 2004–2019, the proportions of MDR-TB, polydrug resistant tuberculosis (PDR-TB), rifampin (RFP)-resistance increased by 160.00%, 18.18%, 231.82%, respectively and the rate of DR-TB among elderly patients with primary cavitary TB increased by 255%. Among the elderly with primary DR-TB during 2004–2019, the proportion of male (from 85.19 to 89.06), cavity (from 7.41 to 46.88), RFP-resistance (from 3.70 to 21.88), and streptomycin (SM)-resistance (from 37.04 to 62.5) increased significantly (P<0.05). And the proportion of female (from 14.81 to 10.94), non-cavity (from 92.59 to 32.81), INH-resistance (from 66.67 to 57.81) decreased significantly (P<0.05).ConclusionAmong the elderly, the proportions of MDR-TB, PDR-TB, RFP-resistance and cavitary DR-TB increased significantly. The pattern of DR-TB changed from female, non-cavity and INH-resistant groups to male, cavity, RFP or SM-resistant groups. For a better control on the elderly DR-TB in the future, we should pay more attention to male, smoking, drinking, chronic obstructive pulmonary disease (COPD) and diabetes subgroups and take targeted measures to control these subgroups.

Active Pulmonary Tuberculosis in Elderly Patients: A 2016-2019 Retrospective Analysis from an Italian Referral Hospital.

Tuberculosis (TB) in the elderly (>65 years old) has increasingly become a global health problem. It has long been recognized that older people are vulnerable to developing tuberculosis. We retrospectively evaluated data from patients older than 65 years diagnosed with pulmonary TB admitted to the National Institute for Infectious Diseases L. Spallanzani, Rome, Italy, from 1 January 2016 to 31 December 2019. One hundred and six consecutive patients were diagnosed with pulmonary TB and 68% reported at least one comorbidity and 44% at least one of the TB risk-factors. Out of the 26 elderly patients who reported an adverse event, having risk factors for TB (O.R. (Odds Ratios) = 1.45; 95% CI 1.12–3.65) and the presence of cavities on Chest X-rays (O.R. = 1.42; 95% CI 1.08–2.73) resulted in being more likely to be associated with adverse events in elderly patients. Having weight loss (O.R. = 1.31; 95% CI 1.08–1.55) and dyspnea (O.R. = 1.23; 95% CI 1.13–1.41) resulted in being significant predictors of unsuccessful treatment outcome in elderly patients. Older people with TB represent a vulnerable group, with high mortality rate, with a challenging diagnosis. Hospitalizations in tertiary referral hospital with clinical expertise in TB management can be useful to improve the outcome of these fragile patients.

A Clinico-radiological presentation of smear positive pulmonary tuberculosis in elderly patient in tertiary care hospital of Bikaner, Rajasthan

A Clinico-radiological presentation of smear positive pulmonary tuberculosis in elderly patient in tertiary care hospital of Bikaner, Rajasthan

Delay on care-seeking and related influencing factors among tuberculosis patients in Wuhan, 2008-2017

Objective: To analyze the epidemiological characteristics, trend and related factors of tuberculosis patients that delayed for care, in Wuhan from 2008 to 2017. Methods: Data regarding tuberculosis (TB) patients was collected from the tuberculosis management information system (TMIS), a part of the China information system for disease control and prevention from 2008 to 2017. A total of 64 208 tuberculosis patients, aged 0 to 95 years were included for the analysis. Unconditional logistic regression method was used to estimate those factors that associated with this study. Results: Days of delay among TB patients appeared as M=10 (P(25)-P(75): 3-28) day, in Wuhan, 2008-2017. The prevalence of the delay was 52.5% (33 703/64 208), presenting a downward trend from 2008 to 2017 (trend χ(2)=10.64, P<0.001), but the proportions of women and ≥65 year-olds were gradually increasing. Results from the multivariate logistic regression analysis showed that factors as: patients living far away from the city vs. near the city (OR=1.29, 95%CI: 1.25-1.35), and age above 45 years vs. younger than 25 years (the age 45-64 years group vs. aged less than 25 years group, OR=1.22, 95%CI: 1.15-1.29; the age 65 or above group vs. aged less than 25 years group, the OR=1.30, 95%CI: 1.22-1.39) were under higher risk on the delay of seeking care. Occupation, way of case-finding and classification of tuberculosis patients also appeared as influencing factors on this issue. Conclusions: Prevalence on the delay of care was 52.5% among tuberculosis patients in Wuhan, 2008-2017, but with an annual decrease. Attention should be paid to female, wrinkly or elderly tuberculosis patients regarding the delay of care on TB, in Wuhan.

Comprehensive Intervention for Anxiety and Depression among the Community Elderly with Tuberculosis

Anxiety and depression are common comorbidities in the elderly who have tuberculosis. We conducted a community-based trial to explore the effect of comprehensive interventions on anxiety and depression of the elderly tuberculosis patients. The control group (n = 122) received health education, and the intervention group (n = 61) received health education, psychotherapy, home visit, peer support, and psycho-educational workshops. Compared with the control group, the anxiety (βGroup×Time = −0.79) and depression (βGroup×Time = −1.13) declined more pronounced in the intervention group. The results suggested that comprehensive interventions could alleviate the anxiety and depression of the elderly tuberculosis patients sustainably and effectively.

Detecting tuberculosis clusters in urban neighborhoods, Taipei, Taiwan: Linking geographic and genotyping evidence

Tuberculosis (TB) clusters, defined as two or more active TB cases with epidemiological links and the same genotype of Mycobacterium tuberculosis strains, are direct evidence of recent TB transmission. We analyzed TB cases newly diagnosed in 2006–2008, confirmed by the diagnostic laboratory, at a university-affiliated hospital in Taipei metropolitan area where TB is endemic in elderly populations. Numbers of randomly selected non-TB patients (as controls) from each district were proportional to the district population (Pearson's correlation coefficient = 0.8), which supports that patients who visited the hospital represent a spatially independent sample of total population in this area. We used the nearest neighbor hierarchical (NNH) clustering method and the spatial scan statistics to identify spatial TB clusters among 969 cases within the 10-km buffer, adjusting for the elderly population. One cluster with 10 TB cases from different households in geographic proximity to each other was detected by both NNH clustering and spatial scan statistics. Spoligotyping and mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) genotyping showed that four of the six M. tuberculosis strains from this spatial cluster were identical. Three of those four patients were older than 70 years, but none were nursing home residents. The identical genotypes of M. tuberculosis strains in clustered elderly TB patients living in neighborhoods indicate that recent transmission plays a significant role in TB endemicity among elderly populations in Taiwan.

A mini systematic review of prognostic factors in elderly patients with tuberculosis.

While advanced age has been suggested as a prognostic factor in patients with tuberculosis, the characteristics associated with a poor outcome in elderly patients have remained unclear. The aim of this systematic review was to describe the risk factors for a poor outcome in elderly patients with tuberculosis. We identified 1255 studies published between 1919 and 2017 from the PubMed database by using combinations of the keywords "tuberculosis [Title/Abstract]" and "elderly [Title/Abstract]". Full texts of the studies that met the inclusion criteria were further evaluated by two independent investigators. even retrospective cohort studies were included in this systematic review. More advanced age, comorbidities, and nutritional status were likely to be prognostic factors in Taiwan (aging country) and Japan (super-aged country), while human immunodeficiency virus infection and severe tuberculosis were associated with a poor outcome in low-income countries. Two studies from Taiwan investigated the prognostic factors of tuberculosis-specific death and non-tuberculosis-specific death separately, but no significant differences were found in the factors between the two types of death. The prognostic factors of tuberculosis in elderly patients varied according to the income levels of the countries. The factors in Taiwan and Japan were mainly associated with host factors, irrespective of the cause of death, which may reflect senile deterioration due to old age.

Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda.

While old age is a known risk factor for developing active tuberculosis (TB), studies on TB in the population aged 60 years and older (considered elderly in this study) are few, especially in the developing world. Results of the TB prevalence survey in Uganda found high TB prevalence (570/100,000) in people over 65. We focused on treatment outcomes in the elderly to understand this epidemic better. We conducted a retrospective analysis of data from TB facility registers in Kampala City for the period 2014–2015. We analyzed the 2014–15 cohort with respect to age, sex, disease class, patients’ human immunodeficiency virus (HIV) and directly observed therapy (DOT) status, type of facility, and treatment outcomes and compared findings in the elderly (≥60) and younger (<60) age groups. Of 15,429 records, 3.3% (514/15,429) were for elderly patients. The treatment success rate (TSR) among elderly TB patients (68.3%) was lower than that of the non-elderly (80.9%) and the overall TSR 80.5%, (12,417/15,429) in Kampala. Although the elderly were less likely to test positive for HIV than the young (AOR 0.39; 95% CI 0.33–0.48, p<0.001), they had a two-fold higher risk of unfavorable treatment outcomes (AOR 2.14; CI 1.84–2.72, p<0.001) and were more likely to die while on treatment (AOR 1.86; CI 1.27–2.73; p = 0.001). However, there was no statistically significantly difference between treatment outcomes among HIV-positive and HIV-negative elderly TB patients. Compared to the younger TB patients, elderly TB patients have markedly poorer treatment outcomes, although TB/HIV co-infection rates in this age group are lower.

Clinical Characteristics of Nursing- and Healthcare-Associated Tuberculosis.

Tuberculosis remains a serious health problem worldwide. Patients with tuberculosis who also require nursing care due to aging and underlying diseases are considered to have a high mortality rate; however, there are few studies describing detailed examinations of such disease conditions. Objective: The present study was conducted to investigate differences in clinical features of elderly tuberculosis patients according to the levels of nursing and healthcare required. Design: The study participants included 146 elderly (≥65 years) patients diagnosed with active tuberculosis among patients hospitalized with tuberculosis at a single center. The patients were classified into two groups: a nursing- and healthcare-associated tuberculosis group (n = 71) and a community-acquired tuberculosis group (n = 75). Results: The nursing- and healthcare-associated tuberculosis patients were older and had a higher frequency of comorbidities compared with the community-acquired tuberculosis group. Patients in the nursing- and healthcare-associated tuberculosis group had markedly lower levels of serum albumin and hemoglobin, and higher levels of C-reactive protein. The rate of in-hospital death was significantly higher in the nursing- and healthcare-associated tuberculosis group. This was attributed to malnutrition and comorbid conditions rather than the severity of tuberculosis. Conclusion: The prognosis was poor in elderly tuberculosis patients receiving nursing and healthcare.

Surgical management for middle or lower thoracic spinal tuberculosis (T5-T12) in elderly patients: Posterior versus anterior approach

BackgroundSpinal tuberculosis accounts for more than 50% of bone tuberculosis cases. This study compared clinical, radiological and functional outcomes between anterior and posterior approaches for treatment of middle or lower thoracic spinal tuberculosis in elderly patients. MethodsWe retrospectively examined middle or lower thoracic spinal tuberculosis (T5–T12) in patients over 65 years. All procedures included debridement, decompression, autologous bone graft and fixation. Surgical procedure, surgical duration, estimated blood loss during surgery and laboratory results were recorded. Pleural effusion volume, thoracic cavity volume, Oswestry Disability Index score, neurological status, radiological parameters and complication rate were evaluated. ResultsNo significant difference was found in surgical duration, blood loss, kyphosis angle correction, loss of correction, thoracic cavity volume, or complication rate between the two groups (P > 0.05). Average postoperative pleural effusion volumes were 605.9 ± 209.5 mL (377–1074 mL) and 262.9 ± 228.1 mL (0–702.4 mL) in the anterior and posterior groups, respectively (P = 0.004). Average hospitalization durations were 26.4 ± 10.5 days (17–53 days) and 19.2 ± 5.0 days (14–30 days) (P = 0.04). Average postoperative serum albumin levels were 24.19 ± 3.84 g/L (19–29.5 g/L) and 28.24 ± 2.52 g/L (24.4–31.6 g/L) (P = 0.01). No relapse or reinfection was observed in either group at the final follow-up. Surgical revision was not required in either group. ConclusionsBoth anterior and posterior surgeries can be used to treat middle or lower thoracic spinal (T5-T12) tuberculosis in elderly patients. In general, the posterior approach might be superior, especially for patients with poor general health.

Pattern of Tuberculosis in Elderly Patients in Egypt

Background and study aim: Tuberculosis (TB) is one of the most prevalent and grave of all humanoid contagious diseases and is still a major infectious disease worldwide. The geriatric population in developed countries represents a big reservoir of tuberculosis infection across all racial and sex subsets. We aim in this study to assess the pattern of TB in elderly patients in Qena governorate in Egypt. Patients and methods: All patients aged 50 years and above who were diagnosed with TB have been included in the study. The patients were evaluated regarding the incidence rate: for new cases, and relapse cases (pulmonary and extra pulmonary).Results: The mean age of included patients was 41.18 years and 51.3% of the studied patients were male. Regarding residence we found 54.7% of patients live in rural areas and 45.3% in urban. 82.9% of the patients were tuberculin positive. As regard chest x-ray finding we found: normal in 17.1% of patients, 17.1% bilateral, 25.6% right upper lobe 16.2% whole right lung, 10.3% left upper lobe, 6% left lower lobe, 3.4% right lower lobe, 2.6% pleural effusion and 1.7% whole left lung. In the present study we found that 81.2% of patients had pulmonary TB and 18.8% had extra pulmonary TB.Conclusion: The study documents important variances in clinical and radiological findings of pulmonary TB in geriatric patients. Sputum analysis for AFB remains a significant, easy and cheap method for diagnosis, but might not be continuously supportive in early diagnosis.

Determinants of mortality in elderly patients with tuberculosis: a population-based follow-up study.

Elderly individuals with tuberculosis (TB) are more likely to have a non-specific clinical presentation of TB and high mortality. However, factors associated with mortality in elderly TB patients have not been extensively studied. This retrospective cohort study aimed to identify factors associated with death among elderly Taiwanese with TB. All elderly patients with TB from 2006 to 2014 in Taipei, Taiwan, were included in a study. Multiple logistic regression was used to identify the factors associated with death in elderly TB patients. The mean age of the 5011 patients was 79·7 years; 74·1% were men; 32·7% had mortality during the study follow-up period. After controlling for potential confounders, age ⩾75 years (reference: 65-74 years), male sex, end-stage renal disease (ESRD), malignancy, acid-fast bacilli-smear positivity, TB-culture positivity, pleural effusion on chest radiograph and notification by an ordinary ward or intensive care unit were associated with a higher risk of all-cause death; while high school, and university or higher education, cavity on chest radiograph and directly observed therapy were associated with a lower risk of all-cause death. This study found that the proportion of death among elderly patients with TB in Taipei, Taiwan, was high. To improve TB treatment outcomes, future control programmes should particularly target individuals with comorbidities (e.g. ESRD and malignancy) and those with a lower socio-economic status (e.g. not educated).

Epidemiological, clinical and evolutionary aspects of tuberculosis among elderly patients of a university hospital in Belém, Pará

Abstract Objective: To evaluate the epidemiological, clinical and evolutionary aspects of tuberculosis in elderly patients of a university hospital in Belém, Pará. Method: A cross-sectional study was conducted in a university hospital, where 82 records of cases of tuberculosis in elderly patients were analyzed. The data was analyzed by applying the G-test, assuming a level of α=0.05 (5%) and a value of p=0.05. Results: Most of the elderly patients were male (64.6%), aged 60-69 years, especially among men (64.2%). Most were new cases of tuberculosis (95.1%), with a pulmonary clinical form (75.6%), associated diseases (69.5%) and a length of stay exceeding 21 days. Fever (67.1%), dyspnea (64.6%), weight loss (61.0%), productive cough (59.8%), chest pain (51.2%) were the main signs and symptoms. Regarding treatment, there was a high percentage of adverse reactions (50%), predominantly gastrointestinal events (70.7%). Most patients were cured (59.8%), but mortality from tuberculosis was considered high (15.9%). In terms of the exposure variables and outcome, there was a statistically significant difference for the age group (p=0.017), length of stay (p=0.000) and adverse reactions (p=0.018) only. Conclusion: The clinical presentation and therapeutic management of tuberculosis among the elderly has characteristics peculiar to this group, making it important to strengthen strategies that facilitate early identification of suspected cases of TB among elderly persons in the community, which should take place mainly through the primary care system.

Influence of old pulmonary tuberculosis on the management of secondary spontaneous pneumothorax in patients over the age of 70 years.

This study aimed to investigate the treatment outcomes and influence of old pulmonary tuberculosis (TB) in elderly patients (over 70 years) with secondary spontaneous pneumothorax (SSP). A retrospective analysis was performed on patients with SSP between January 2002 and December 2014. Treatment outcomes including chest tube duration (CTD), type and complication of surgery, recurrence and survival rate were obtained from the review of medical records and analyzed statistically. Two hundred and sixteen consecutive cases were recruited. Of these, 134 (62.0%) did not have old pulmonary TB [non-tuberculosis (NTB) group], and the other 82 (38.0%) had experienced pulmonary TB (TB group). More thoracoscopic surgeries had been performed in the NTB group (P=0.038). More postoperative complications developed in the TB group (P=0.038). Total CTD and postoperative CTD in the TB group were significantly longer (P=0.015 and 0.030, respectively). However, recurrence-free survival and overall survival rate were not significantly different between the TB and NTB groups. Old pulmonary TB in elderly patients with SSP made their treatment more complicated. However, surgery might be considered in highly selected patients regardless of old pulmonary TB, and could be conducted with acceptable morbidity and mortality.

The Value of T-SPOT.TB Technology in the Diagnosis of Tuberculosis in Elderly Patients

The Value of T-SPOT.TB Technology in the Diagnosis of Tuberculosis in Elderly Patients

Diagnostic delay of pulmonary tuberculosis in patients with acute respiratory distress syndrome associated with aspiration pneumonia: Two case reports and a mini-review from Japan.

Diagnosing active tuberculosis in elderly patients presents problems due to nonspecific symptoms and complications such as aspiration pneumonia. The current study presents two cases of pulmonary tuberculosis with bilateral pulmonary infiltrates associated with aspiration pneumonia. The two elderly patients developed acute respiratory distress syndrome as a result of aspiration pneumonia. The diagnoses of pulmonary tuberculosis were delayed in both cases, as the patients were diagnosed with active tuberculosis following discharge from hospital. The sputum test for acid-fast bacillus at the time of administration was smear-negative/culture-positive in these patients. They were treated with isoniazid, rifampicin and ethambutol, and nosocomial transmission of tuberculosis from these patients was not reported. The number of elderly patients with aspiration pneumonia is predicted to increase rapidly, and aspiration pneumonia combined with pulmonary tuberculosis is a major medical and healthcare concern in Japan. The present study concludes that physicians should always consider the complication of pulmonary tuberculosis when treating pneumonia patients, in particular in treating elderly patients with pulmonary infiltrates.

Speech of nurse managers related to conditions that (dis)favor the control of tuberculosis in the elderly.

To analyze the discourse of nurse managers related to conditions that (dis)favor the control of tuberculosis in the elderly. This study is qualitative and was held in a city considered a priority in the control of tuberculosis in Paraiba. Data collection was carried out between February and May 2014, through semi-structured interviews with eleven nurse managers. French Discourse Analysis was used the to analyze the empirical material. The following discursive block was identified in the analysis: Conditions that (dis)favor the control of tuberculosis in the elderly. It was made evident that the training processes represent an important component in the effective control of this disease in the elderly. However, the speeches pointed to the maintenance of traditional educational practices in training and that tuberculosis in older people is not perceived as a priority. The nurse managers should trigger training processes to improve the control of tuberculosis in elderly patients based on continuing health education.

Application of tuberculosis infection of T cells spot test in the diagnosis for pulmonary tuberculosis in elderly pa-tients with chronic obstructive pulmonary disease

Objective To investigate the application value of tuberculosis infection of T cells spot test in the diagnosis for pulmonary tuberculosis in elderly patients with chronic obstructive pulmonary disease (COPD). Methods According to test different ways,64 elderly COPD patients with pulmonary tuberculosis were divided into the two groups.The control group(n=32)was checked by tuberculosis antibody test,and the study group(n=32)received T cells infected with tuberculosis spot test.The two sets of results were observed and compared. Results The study group by T cell spot test TB infection,29 cases were detected positive(90. 63%),3 cases of negative(9.37%);tuberculosis antibody detection by the control group,23 cases were detected positive(71.88%),9 negative patients(28.12%).Compared the two groups,the study group had higher positive rate(χ2=3.954 7,P<0.05),and negative rate was lower(χ2=3.914 7,P<0.05). Conclusion Tuberculosis infection T cell spot test in the diagnosis of pulmonary tuberculosis in patients with COPD in the elderly has greater value,more accurate diagnosis,reliability and worthy of promotion. Key words: Pulmonary Disease,Chronic Obstructive; Tuberculosis,Pulmonary; T-Lymphocytes; Aged