title: Prevalence of tuberculous infection and active tuberculosis in old age homes in Hong Kong.
abstract: OBJECTIVE
  To assess the prevalence of tuberculous infection and active tuberculosis (TB) in old age homes in Hong Kong and to determine whether there is institutional transmission in these homes.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Old age homes.
  
  
  METHODS
  Total of 2,243 residents, representing 84.6% of all residents in 15 old age homes; 1,698 were women, and 545 were men, with an average age of 82.
  
  
  METHODS
  All residents had a questionnaire-based interview, medical record review, two-stage tuberculin testing using two units purified protein derivative-RT23, and a chest x-ray. Those with radiological abnormalities had sputum examined for acid-fast bacilli.
  
  
  RESULTS
  The estimated prevalence rate of active TB in this population was 669 per 100,000, significantly higher in men than in women (1,101 per 100,000 vs 530 per 100,000). The proportion with positive tuberculin reactivity (> or =10 mm induration) after two-stage testing was 68.6%, significantly higher in men than in women. There was no evidence of active transmission of disease in these old age homes, with restriction fragment length polymorphism (RFLP) analysis performed on five cases of active pulmonary TB in the home with the highest rate of TB showing unique RFLP patterns.
  
  
  CONCLUSIONS
  The rate of active TB and TB infection in old age homes in Hong Kong is still high. Because treatment for latent TB carries a high risk for liver dysfunction in this population, clinicians and other healthcare workers need a high index of suspicion and to diagnose and treat this disease as early as possible to prevent transmission.
authors.affiliation: Respiratory Division, Department of Medicine, University of Hong Kong, Hong Kong, China. mmwchan@hkucc.hku.hk
authors.forename: Moira
authors.initials: M
authors.lastname: Chan-Yeung
authors.forename: Felix H W
authors.initials: FH
authors.lastname: Chan
authors.forename: Amy H K
authors.initials: AH
authors.lastname: Cheung
authors.forename: David L K
authors.initials: DL
authors.lastname: Dai
authors.forename: Leung-Wing
authors.initials: LW
authors.lastname: Chu
authors.forename: Wah-Kit
authors.initials: WK
authors.lastname: Lam
authors.forename: Chi-Chiu
authors.initials: CC
authors.lastname: Leung
authors.forename: Kai-Man
authors.initials: KM
authors.lastname: Kam
authors.forename: Cheuk-Ming
authors.initials: CM
authors.lastname: Tam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D006707:Homes for the Aged; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*