title: Profile and response to anti-tuberculosis treatment among elderly tuberculosis patients treated under the TB Control programme in South India.
abstract: BACKGROUND
  The demographic transition in India has resulted in an increase in the elderly population. There is limited data on the profile of elderly tuberculosis (TB) patients and their treatment outcomes in India.
  
  
  OBJECTIVE
  To compare the clinical profile, presentation and response to anti-TB treatment among elderly (≥ 60 yrs) and younger (15-59 yrs) TB patients treated under the Revised National TB Control programme.
  
  
  METHODS
  Retrospective cohort analysis of TB patients treated from May 1999 to December 2004 in one Tuberculosis Unit of Tiruvallur district, South India.
  
  
  RESULTS
  Records of 865 elderly and 4343 younger TB patients were examined: elderly were more likely to be male (84% vs. 71%), smokers (46% vs.37%), illiterate (63% vs. 45%), identified by active case finding through survey (19% vs. 11%), have pulmonary TB (96% vs. 91%) and initial smear negative disease (46% vs. 36%) compared to younger (for all p<0.001). Among a total of 352 elderly and 1933 younger new smear positive pulmonary TB, the elderly had higher loss to follow-up (15% vs. 11%; p = 0.03) and death rates (9% vs. 4%; p<0.001). Mycobacterium tuberculosis susceptibility to first line anti-TB drugs did not differ (elderly 87% vs. younger 84%) (p = 0.20). Side effects related to anti-TB drugs were reported by a higher proportion of elderly patients (63% vs. 54%) (p = 0.005). Previously treated patients had similar treatment outcomes in both the groups.
  
  
  CONCLUSIONS
  Elderly TB patients are less likely to have smear positive disease. Newly diagnosed elderly TB patients are more likely to be lost to follow-up or die and report drug side effects. Suitable interventions need to be developed for effective management and better treatment outcomes of TB in the elderly.
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Banu Rekha Vaithilingam
authors.initials: BR
authors.lastname: Velayutham
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Dina
authors.initials: D
authors.lastname: Nair
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Vedachalam
authors.initials: V
authors.lastname: Chandrasekaran
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Balambal
authors.initials: B
authors.lastname: Raman
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Gomathy
authors.initials: G
authors.lastname: Sekar
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Basilea
authors.initials: B
authors.lastname: Watson
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Niruparani
authors.initials: N
authors.lastname: Charles
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Muniyandi
authors.initials: M
authors.lastname: Malaisamy
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Aleyamma
authors.initials: A
authors.lastname: Thomas
authors.affiliation: National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Chennai, India.
authors.forename: Soumya
authors.initials: S
authors.lastname: Swaminathan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D015897:Comorbidity; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D009313:National Health Programs; D016017:Odds Ratio; D062486:Public Health Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents