Positive Sputum Smear Microscopy Research Articles

Relevance of the correlation between tomography findings and laboratory test results in the accuracy of the diagnosis of pulmonary tuberculosis.

To evaluate the correlation between multidetector computed tomography (MDCT) findings and laboratory test results in patients with pulmonary tuberculosis (PTB). A total of 57 patients were evaluated. Patients with suspected PTB were divided into groups according to the final diagnosis (confirmed or excluded), and the groups were compared in terms of sociodemographic variables, clinical symptoms, tomography findings, and laboratory test results. Among the patients with a confirmed diagnosis of PTB, small pulmonary nodules with a peribronchovascular distribution were significantly more common in the patients with a positive sputum smear microscopy result (47.4% vs. 8.3%; p = 0.046), as were a miliary pattern (36.8% vs. 0.0%; p = 0.026), septal thickening (84.2% vs. 41.7%; p = 0.021), and lymph node enlargement (52.6% vs. 8.3%; p = 0.020). Small pulmonary nodules with a centrilobular distribution were significantly more common among the culture-positive patients (75.0% vs. 35.7%; p = 0.045), as was a tree-in-bud pattern (91.7% vs. 42.9%; p = 0.014). A tree-in-bud pattern, one of the main tomography findings characteristic of PTB, had a sensitivity, specificity, positive predictive value, and negative predictive value of 71.0%, 73.1%, 75.9%, and 67.9%, respectively. MDCT presented reliable predictive values for the main tomography findings in the diagnosis of PTB, being a safe tool for the diagnosis of PTB in patients with clinical suspicion of the disease. It also appears to be a suitable tool for the selection of patients who are candidates for more complex, invasive examinations from among those with high clinical suspicion of PTB and a negative sputum smear microscopy result.

Sociodemographic and Clinical Factors Associated with Treatment Outcomes for Drug-resistant Tuberculosis.

Drug-resistant tuberculosis (DR-TB) continues to be a serious public health problem. The objective of this study was to evaluate the sociodemographic, radiological, clinical, and outcome characteristics and assess the determinants of unfavorable outcomes in DR-TB. The descriptive-analytical study was carried out in a reference outpatient clinic in Rio de Janeiro, Brazil, among DR-TB cases that received treatment between February 2016 and October 2020, using descriptive statistics, χ2 test, and logistic regression multivariate. Of the 148 cases, 12.2% were resistant to rifampicin, 12.2% were resistant to isoniazid, 18.2% were polyresistant, 56.1% multidrug resistant, and 1.3% were extensively drug resistant. Most of the patients were men, aged up to 44 years, with brown or black skin, having up to 8 years of schooling, unemployed or working in the informal economy, and of low income. Presenting with acquired resistance or positive sputum smear microscopy in the diagnosis, taking more than four drugs, and being unemployed were associated with unfavorable outcomes. Having no income or acquired resistance doubled the chances of unfavorable outcomes. There was a high proportion of unfavorable outcomes, thereby highlighting the need to concentrate efforts on planning and executing public policies that include the severity of DR-TB and its risk factors.

Acquired and Transmitted Multidrug-Resistant Tuberculosis among the Incarcerated Population and Its Determinants in the State of Paraná-Brazil.

(1) Background: Tuberculosis remains a public health problem in the world. The study analyzed the factors associated with drug-resistant tuberculosis in the prison population of the state of Paraná. (2) Methods: Ecological study of drug-resistant tuberculosis cases registered in the Paraná Information System, Brazil (2008 to 2018). We performed descriptive statistics of quantitative parameters calculated with absolute frequencies. Additionally, we used binary regression logistics, where the odds ratio with its respective confidence interval was calculated. (3) Results: Of the 653 cases registered as cases of tuberculosis in the incarcerated population, 98 were drug-resistant tuberculosis. We observed that educational level of up to 8 to 11 years of schooling, negative bacterial culture (test outcome) and no tobacco use were factors associated with the non-development of drug-resistant tuberculosis, while clinically confirmed pulmonary TB and positive sputum smear microscopy in the fourth month of follow-up showed an association for the development of drug resistance. (4) Conclusions: The study showed that clinically confirmed pulmonary TB and a positive sputum smear microscopy in the fourth month of follow-up were associated with drug-resistant tuberculosis.

Clinical, laboratory, and radiographic aspects of patients with pulmonary tuberculosis and dysglycemia and tuberculosis treatment outcomes.

To analyze the association of dysglycemia with clinical, laboratory, and radiographic characteristics of patients with pulmonary tuberculosis (PTB), as well as with their tuberculosis treatment outcomes. This was a longitudinal study involving 140 patients diagnosed with PTB (positive cultures for Mycobacterium tuberculosis or positive Xpert MTB/RIF results from sputum samples). Patients were evaluated at diagnosis (M0), after completing the second month of treatment (M2), and at the end of treatment (MEND). At M0, the patients were classified into three groups: normoglycemia+PTB (NGTB); pre-diabetes mellitus+PTB (PDMTB), and diabetes mellitus+PTB (DMTB), in accordance with glycated hemoglobin levels (< 5.7%, 5.7%-6.4%, and ≥ 6.5%, respectively). Treatment outcomes were classified as favorable (cure or treatment completion) and unfavorable (death, loss to follow-up, or treatment failure). In our sample, 76 patients (61.4%) had dysglycemia, 20 of whom (14.3%) had DM at M0. The patients with dysglycemia, in comparison with those in the NGTB group, more frequently presented with positive sputum smear microscopy (94.2% vs. 75.9%; p = 0.003); cavities (80.2% vs. 63.0%; p = 0.03); bilateral lesions (67.4% vs. 46.0%; p = 0.02); and higher median of affected thirds of the lungs (3.0 vs. 2.0; p = 0.03) on chest radiography. No significant differences regarding outcomes were found among the groups, but tuberculosis lethality was higher in the DMTB group than in the PDMTB and NGTB groups (20% vs. 2.2%). PTB patients with dysglycemia had laboratory and radiographic manifestations indicative of more advanced disease, and the risk of death was higher in the DMTB group. These findings reinforce the recommendation for early screening for DM in patients with newly diagnosed tuberculosis in order to reduce the risk of death during treatment.

Tuberculosis treatment outcomes in children

The objective of the study: to assess tuberculosis treatment outcomes in children of 0-14 years old following up changes over the time Subjects and Methods: A retrospective cohort analysis of tuberculosis outcomes in 15,794 children of 0-14 years old was performed, those children were registered for treatment from 2011 to 2018. Results. The percentage of children switched to MDR regimens increased from 1.3% to 12.0%. The rate of successful treatment of new TB cases in children varied from 93.2% to 96.6% in different years. In children registered for treatment in 2016-2018, 95.7% of new cases with negative or undocumented sputum smear microscopy, 87.8% with positive sputum smear microscopy, and only 83.3% of children with TB relapse were successfully treated. From 2015 to 2018, the percentage of children with treatment failures increased from 0.6% to 1.5%. Conclusion. Compared to other countries, Russia has a high rate of successful treatment in children with tuberculosis which may be due to their active detection. Nevertheless, there are certain defects in drug susceptibility testing of index cases. Treatment outcomes for children registered in 2020 are expected to be less favorable because of later detection due to the COVID-19 pandemic. The spread of HIV infection among children as well poses a threat of increased mortality in children ill with tuberculosis. To reduce the level of unfavorable outcomes, it is necessary to consider the treatment of children at the age of 0-14 years old ill with tuberculosis in federal centers.

Factors associated with time to sputum culture conversion of rifampicin-resistant tuberculosis patients in Klaipeda, Lithuania in 2016-2019: a cohort study.

The global proportion of successful treatment outcomes of Multidrug-Resistant/Rifampicin-Resistant Tuberculosis (MDR/RR-TB) remains unacceptably low. Time to culture conversion is important in making treatment-related decisions and is used as an interim predictor of pulmonary MDR/RR-TB treatment success. No previous studies have been conducted to assess determinants of time to culture conversion for MDR/RR-TB patients in Lithuania. Secondary analysis of data of culture-positive MDR/RR-TB patients, treated in Republican Klaipeda Hospital between 1st July 2016 and 1st July 2019 was performed. Culture conversion was defined as two consecutive negative cultures on solid media submitted at least 30 days apart. Factors associated with culture conversion were estimated by crude and multivariable Cox regression accounting for competing risks.In total, 115 consecutive patients starting treatment were included in the study. Of them, the majority was male (86/115; 74.8%) with a mean age of 48 (standard deviation (SD) ±12) years and Human Immunodeficiency Virus (HIV) negative (105/115; 91.3%). Nearly two-thirds (72/115; 62.6%) had XDR (extensive drug resistance) or MDR/RR-TB with additional resistance to second-line injectables or fluoroquinolones. Of 115 culture-positive patients at baseline, 103 (89.6%) patients achieved culture conversion during 12 months of treatment. The median time to culture conversion was 1.1 months (interquartile range: 0.9-1.8). Patients aged ≥60 years compared with <40 years [adjusted hazard ration (aHR): 0.40, 95% confidence interval (CI): 0.18-0.86], smokers (aHR: 0.39, 95% CI: 0.2-0.73), patients with positive sputum smear microscopy at baseline (aHR: 0.40, 95% CI: 0.25-0.63), cavities on initial chest X-ray (aHR: 0.56, 95% CI: 0.35-0.88) and resistance to at least one fluoroquinolone drug (aHR: 0.52, 95% CI: 0.32-0.84) were slower to culture convert. In conclusion, we recommend providing additional counseling, treatment adherence interventions and scale up the use of new and repurposed TB drugs to patient groups at risk of worse interim treatment outcome: patients aged 60 and above, with resistance to fluoroquinolones, smear-positive, smokers, or with signs of extensive disease evident on initial chest radiography.

Tuberculosis and diabetes: association with sociodemographic characteristics and diagnosis and treatment of tuberculosis. Brazil, 2007-2011.

Tuberculosis and diabetes comorbidity remains a challenge for global public health. To analyze the sociodemographic profile and the diagnostic and treatment characteristics of tuberculosis cases with and without diabetes in Brazil. This is a cross-sectional study with data from the Notifiable Diseases Information System and the Hypertension and Diabetes Mellitus Primary Care Clinical Management System, from 2007 to 2011. We adopted a Poisson regression model with robust variance to estimate the prevalence ratios (PR) and their respective confidence intervals. We found the studied comorbidity in 7.2% of cases. The hierarchical model showed a higher PR among women (PR=1.31; 95% confidence interval - 95%CI 1.27-1.35); a greater association in the age groups 40-59 years and ≥ 60 years (PR=11.70; 95%CI 10.21-13.39, and PR=17.49; 95%CI 15.26-20.05), and in those with positive sputum smear microscopy results - 1st sample (PR=1.40; 95%CI 1.35-1.47). Return after treatment discontinuation and treatment discontinuation were inversely associated with comorbidity (PR=0.66; 95%CI 0.57-0.76 and PR=0.79; 95%CI 0.72-0.87). The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.

RELATIONSHIP BETWEEN SUCCESSFUL TREATMENT OF PULMONARY TUBERCULOSIS PATIENTS WITH THE AVAILABILITY OF TREATMENT SUPPORTER IN ATMA JAYA HOSPITAL

Introduction: One of the biggest health problems faced by community is pulmonary tuberculosis (TB).TB is an respiratory tract infectious disease caused by Mycobacterium Tuberculosis. World Health Organization (WHO) recommends TB treatment with Directly Observed Treatment Short-course (DOTS) strategy, one of which is through the help of treatment supporter (PMO or Pengawas Minum Obat) who supervises the patient during the treatment period.&#x0D; Methods: This was an analytic descriptive study with cross sectional approach.. Respondents were taken by consecutive sampling, based on medical records at Atma Jaya Hospital. We applied inclusion criteria such as newly diagnosed TB patient with positive sputum smear microscopy results, adult TB patient who has finished 6 month of treatment and patients who have done sputum smear microscopy test after finishing their TB treatment. The exclusion criteria were TB-HIV patients and Milliary TB patients. After fulfilment of those criteria, a total of 81 respondents were selected. Data was analysed by Chi Square test (Fisher Exact test).&#x0D; Results: Most of patients were 15-50 years old (70,4%) with mean age at 38.49±17.83 years old),male (53.1%), had family as treatment supporter (91.4%) and had successful TB treatment (74.1%). TB patients with treatment supporter had more successful treatment (66.7%) than TB patients with no treatment supporter (7.4%), however there was no significant among the avalibility of treatment supporter and the success of TB treatment (p=0.670).&#x0D; Conclusion: Despite the insignificant result, this study gives good insight to implementation of TB DOTS strategy in Atma Jaya Hospital. The implementation of this strategy contributes to imbalance number of samples between patient with and without treatment supporter, leading to overestimate results on with TB treatment supporter group.

Tuberculosis treatment and Smoking, Armenia, 2014–2016

IntroductionTuberculosis and tobacco prove to be increasingly apparent world problems. Armenia is a developing country which is facing issues related to the high rates of tobacco consumption. Moreover, it is among the list of high multi-drug resistant (MDR) Tuberculosis TB burden countries. Treatment success rate in Armenia for sputum smear-positive cases never reached World Health Organization's (WHO) target of 85% in last 15 years. Data from different studies completed across the world suggests that there is an association between smoking and negative treatment outcomes. MethodsThis retrospective study was designed to investigate aforementioned associations between TB treatment outcomes and smoking status of TB patients. Data for the study were derived from the national data available in the electronic database of the Armenian National TB Center. ResultsBased on inclusion and exclusion criteria 992 TB patients registered in 2014 were enrolled in this study. All of them are were TB patients in which 387 were smokers and 605 were non-smokers. Notably, adjusted analysis showed that individuals who smoked during TB treatment had 1.61 higher odds of having unsuccessful TB treatment outcome. Additionally, consistent with the literature, statistically significant association was identified between TB treatment outcome and other well factors such as sputum smear status (OR=2.24, p<0.01), HIV status (OR,=1.87, p<0.01) of patients, etc. ConclusionsThe smoking, HIV positive status, positive sputum smear microscopy test were identified as an important factors associated with the unsuccessful TB treatment outcome in Armenia. It highlights the necessity of having specific restrictions and campaign programs to reduce smoking rates among TB patients in order to improve current TB treatment and care services throughout Armenia.

Perfil clínico e epidemiológico e prevalência da coinfecção tuberculose/HIV em uma regional de saúde no Maranhão

To describe the clinical and epidemiological profile, as well as the prevalence, of tuberculosis/HIV co-infection in the Regional Health District of Tocantins, which serves 14 cities in the state of Maranhão, Brazil. This was a descriptive epidemiological study based on secondary data obtained from individual tuberculosis reporting forms in the Brazilian Case Registry Database. We included all reported cases of tuberculosis/HIV co-infection, by city, between January of 2001 and December of 2010. In the district, 1,746 cases of tuberculosis were reported. Of those tested for HIV, 100 had positive results, which corresponded to a tuberculosis/HIV co-infection prevalence of 39%. Of the co-infected patients, 79% were male, 42% were Mulatto, and 64% were in the 20- to 40-year age bracket, 31% had had < 4 years of schooling, and 88% resided in the city of Imperatriz. Cases of pulmonary tuberculosis and new cases of tuberculosis predominated (in 87% and 73%, respectively). Of the co-infected patients, 27% had positive sputum smear microscopy results, and 89% had chest X-ray findings suggestive of tuberculosis. Sputum culture was performed in only 7% of the cases. Our results show that, because of its clinical and epidemiological profile, tuberculosis/HIV co-infection is still a major public health problem in the southwestern region of Maranhão. This situation calls for better coordination between tuberculosis and sexually transmitted disease/AIDS control programs, as well as a political commitment and greater involvement on the part of administrators and health care professionals in the planning of interventions and the functioning of health care facilities.

Clofazimine in the treatment of multidrug-resistant tuberculosis

Clofazimine has shown activity against Mycobacterium tuberculosis, including multidrug-resistant strains in vitro and in animal studies. However, clinical experience with clofazimine in multidrug-resistant tuberculosis (MDR-TB) is scarce. We reported our clinical experience with 39 MDR-TB patients treated with combination regimens that included clofazimine. From January 2008 to March 2011, 39 patients received clofazimine for the treatment of MDR-TB in Shanghai Pulmonary Hospital. Patients had isolates resistant to a median of six drugs (range, 2–11 drugs). Of the 39 cases, 36 had cavitary changes noted on initial chest radiograph or chest computed tomography, and positive sputum-smear microscopy results at the time of MDR-TB diagnosis. At data censure, 15 of the 39 patients had successful therapy, with at least five consistently negative cultures documented for the final 12 months of treatment. Eleven continued to receive treatment. There were no deaths. Thirteen patients had a poor outcome, including four defaults and nine treatment failures. Culture conversion occurred in 22 cases at a median of 12 weeks. Side-effects occurred in 34 patients, mainly including skin discolouration, ichthyosis and gastrointestinal adverse events. No patients reported significant toxicity likely to be attributable to clofazimine therapy. Adverse events were managed by combinations of dose adjustment and symptom management. In our experience, clofazimine was well tolerated and may have efficacy in the treatment of MDR-TB.

Demographic and clinical characteristics of tuberculosis: A report of 2404 cases at a referral hospital

The aim of this study was to evaluate the demographic and clinical characteristics of patients with tuberculosis in a state referral hospital for the treatment of tuberculosis. Epidemiological investigation carried out as retrospective, descriptive, observational study based on the medical charts of 2404 consecutive patients diagnosed with tuberculosis between 2003 and 2010. Of these, 1721 (71.6%) were males, 683 (28.4%) were females, 35% were smokers and 12% suffered from alcoholism. The mean age of the study group was 42.6 (range from 15 to 89) years. 74.7% of the cases had or had not received an elementary school education. 64% of the patients were unoccupied and 12.8% were farm workers. Pulmonary (81%) and pleural (12%) tuberculosis were observed as the most common clinical forms. The prevalence of exposure to tuberculosis was 26%. The most frequent symptoms during admission were cough, weight loss, fatigue, sputum and night sweating, respectively. Diabetes mellitus was the most frequent comorbidity with an incidence of 7.9%. In pulmonary involvement, the rates of sputum smear examination, positive sputum smear microscopy and positive Lowenstein-Jensen culture forMycobacterium Tuberculosis were reported as 82.9, 62 and 70.7%, respectively. Most common radiological patterns were parenchymal infiltrate (48.8%) and cavitation (28.9%) in pulmonary tuberculosis. As a result, tuberculosis is seen more frequently in male, low educated, unemployed and lower income subjects of population. Marked pulmonary involvement and notably initial exposure to tuberculosis are the other remarkable findings. Key words: Tuberculosis, demography, epidemiology.

Linezolid in the treatment of MDR-TB: a retrospective clinical study

There is limited information on Chinese patients with multidrug-resistant tuberculosis (MDR-TB) treated with a linezolid-containing regimen. To examine treatment outcomes among MDR-TB patients who were treated with linezolid at the Shanghai Pulmonary Hospital, China. We retrospectively reviewed 151 patients who were treated for MDR-TB from 2007 to 2010. Eighteen MDR-TB patients, including 15 with extensively drug-resistant TB, received linezolid as part of their individualised treatment regimens. Patients had isolates resistant to a median of 7 drugs (range 5-11). Of the 18 cases, 17 had cavitary changes and positive sputum smear microscopy results at the time of MDR-TB diagnosis. Culture conversion occurred in all cases at a median of 7 weeks. At data censure, 9 of the 18 patients had achieved treatment success. Three continued to receive treatment. There were no deaths. Six patients had a poor outcome, including 1 default, 2 treatment failures and 3 relapses. Side effects occurred in 17 patients, including myelosuppression, neurotoxicity and gastrointestinal adverse events. Adverse events were managed by combinations of temporary suspension of linezolid in 1 patient, dose adjustment in 17 patients and symptom management in 13 patients. Linezolid may have efficacy in the treatment of MDR-TB, although treatment was complicated by adverse events.

Failing a re-treatment regimen does not predict MDR/XDR tuberculosis: is "blind" treatment dangerous?

To the Editors: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) represent an emerging public health threat worldwide 1. The Stop TB Strategy has been revised to provide universal access to diagnosis and treatment for all patients with MDR-TB by 2015 2–4. This plan calls for accelerated access to culture for mycobacteria, species identification and drug susceptibility testing (DST) of Mycobacterium tuberculosis . However, in several countries, appropriate TB laboratory facilities are still largely unavailable. In the absence of culture and DST, TB patients failing a re-treatment regimen have been considered eligible for treatment regimens with second-line drugs, under the assumption that ≥80% of them would harbour MDR M. tuberculosis strains 5. In Burkina Faso, as in most low- and some middle-income settings, pulmonary TB cases failing a standard category II regimen are only identified by positive sputum smear microscopy at the end of the fifth month of treatment and are defined as “chronic” TB patients. The diagnosis of chronic TB has significant implications. National guidelines for the management of chronic TB cases in Burkina Faso recommend hospital admission and in-patient treatment for ≥6 months with a standardised category IV treatment regimen 6. Although the diagnosis of chronic TB is taken as a surrogate marker for the identification of MDR-TB, little evidence is available from the literature on its positive predictive value for MDR-TB diagnosis. We systematically performed microbiological investigations, which included both phenotypic and genotypic techniques, on all newly identified chronic TB cases diagnosed over a 2-yr period in Burkina Faso. Here, we report the results and discuss the implications that “blind” treatment with second-line drugs have at programmatic level. A prospective, country-wide investigation was performed to microbiologically characterise all consecutively registered chronic TB cases in Burkina Faso, defined on the basis of …

Incidência de TB diagnosticada no pronto-atendimento de um hospital escola na região sudeste do Brasil

In this study, we analyzed the number of TB cases in an emergency room (ER) and the susceptibility profile of Mycobacterium tuberculosis strains. Patients were selected from among those treated at the Hospital das Clínicas, in the city of Belo Horizonte, Brazil. Between 2002 and 2005, 240 TB patients were identified. Of those, 117 patients (48.7%) were diagnosed in the ER, 72 (61.5%) presenting positive sputum smear microscopy. Drug susceptibility testing was carried out in 90 strains, of which 80 (89%) were sensitive, 9 (10%) were resistant, and 1 (1%) was multidrug resistant. The incidence of positive smear sputum microscopy and resistant TB strains was high, which calls for the immediate adoption of TB control measures in the ER.

Manifestation of tuberculosis in patients with human immunodeficiency virus: A large Indian study

BACKGROUND:Government Hospital of Thoracic Medicine, Tambaram Sanatorium, Chennai, is the largest HIV-care center in South East Asia. As many as 29,300 HIV patients visited this center at least once in the year 2005 for care and support.OBJECTIVES:Clinical manifestations and the modes of presentation of tuberculosis were assessed among 12,750 adult and adolescent patients with human immunodeficiency virus (HIV) attending the hospital for the first time.MATERIALS AND METHODS:Database of Hospital Information System, specially evolved for managing patients afflicted with tuberculosis and HIV, was utilized. The particulars confined to patients with tuberculosis and HIV co-infection who visited the hospital for the first time from January to December 2005 were considered for the analysis. Proportion test and Chi-square test with Yates correction were done.RESULTS:As many as 12,750 adult and adolescent HIV-confirmed patients were screened for the possible presence of tuberculosis. Out of them, 4,383 (34.4%) patients had tuberculosis. Among them, 2,448 (55.9%) had pulmonary tuberculosis, and the remaining 1,935 (44.1%) had either disseminated or extra-pulmonary tuberculosis (P<0.001). Positive sputum-smear microscopy for acid fast bacilli was evident in 1,363 (31.1%) patients; however, it was significantly lower compared to positive smear rate of 44% in HIV patients (P< 0.001).CONCLUSION:Tuberculosis was found to be the predominant co-infection among the symptomatic patients infected with HIV attending the largest care center for the first time in India. Advanced tuberculosis, disseminated tuberculosis and sputum smear negative pulmonary tuberculosis were the presenting clinical manifestations in 44% of the patients, as they had moderate to advanced immunosuppression. Early detection of tuberculosis co-infection is absolutely necessary.

Características da tuberculose em idosos no Recife (PE): contribuição para o programa de controle

To describe the demographic characteristics, everyday habits, socio-economic conditions, clinico-epidemiological profiles and access to health care services among the elderly patients with tuberculosis diagnosed and treated in the city of Recife, Brazil, comparing them to those observed in young adults with tuberculosis. A case-control type strategy was used to evaluate a cohort of patients with tuberculosis, all of whom were treated in public health care facilities in Recife between May of 2001 and July of 2003. The final cohort consisted of 1127 patients: 136 elderly patients (cases) and 991 young adults (controls). In both groups, males predominated, and the most common form of tuberculosis was the pulmonary form. Alcoholism was more common in the control group, whereas illiteracy was more common in the case group. There were fewer complaints of cough, sweats and chest pain among the patients in the case group than among those in the control group. Serological testing for the human immunodeficiency virus was performed in only 29 patients (2.6%). The percentage of positive sputum smear microscopy results, as well as that of positive cultures, was higher in the controls. Prior to being diagnosed with the disease, patients in both groups had sought treatment at more than two health care facilities and had waited more than two months (after first seeking treatment). The elderly patients presented higher indices of cure and were more often compliant with the treatment regimen, yet presented higher mortality rates. In the population studied, the elderly presented less cough, fewer episodes of night sweats and less chest pain, as well as less often presenting positivity on complementary exams. Nevertheless, the mortality rate was higher among the elderly patients than among the young adult patients. Elderly patients with tuberculosis constitute a population that should be given special attention in public health care facilities.