title: Tuberculosis case burden and treatment outcomes in children, adults and older adults, Vanuatu, 2007-2011.
abstract: METHODS
  All five DOTS centres in Vanuatu.
  
  
  OBJECTIVE
  To determine across the age spectrum the tuberculosis (TB) case burden, disease pattern and treatment outcomes in patients registered between 2007 and 2011.
  
  
  METHODS
  Retrospective cohort study involving reviews of TB registers and treatment cards.
  
  
  RESULTS
  Of 588 TB patients, 142 (24%) were children (aged 0-14 years), 327 (56%) adults (aged 15-54 years) and 119 (20%) were older adults (aged ⩾55 years; subdivided into 55-64 and ⩾65 years); 568 were new patients, 13 had been treated previously and 7 had unknown status. Compared with adults, children with new TB had a higher prevalence of extra-pulmonary TB (75% vs. 34%, OR 5.7, 95%CI 3.6-9.0) and a lower prevalence of smear-positive pulmonary TB (11% vs. 45%, OR 0.15, 95%CI 0.1-0.3), while older adults with new TB had a higher prevalence of smear-negative pulmonary TB (38% vs. 21%, OR 2.4, 95%CI 1.5-3.8). Overall TB treatment success was 83%, but in the second category of older adults (⩾65 years) treatment success was 67% and case fatality was 18%.
  
  
  CONCLUSIONS
  Children and older adults constitute 45% of the TB burden in Vanuatu. Differences in disease patterns and poorer treatment outcomes in older adults have implications for policy and practice.
authors.affiliation: National TB Control Programme, Port Vila, Vanuatu.
authors.forename: M
authors.initials: M
authors.lastname: Tagaro
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: School of Population Health, The University of Auckland, Auckland, New Zealand.
authors.forename: B
authors.initials: B
authors.lastname: Kool
authors.affiliation: College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
authors.forename: S
authors.initials: S
authors.lastname: Ram
authors.affiliation: Secretariat of the Pacific Community, Nouméa, New Caledonia.
authors.forename: K
authors.initials: K
authors.lastname: Viney
authors.affiliation: The Sydney Emerging Infections and Biosecurity Institute, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Marais
authors.affiliation: Department of Public Health, Ministry of Health, Port Vila, Vanuatu.
authors.forename: L
authors.initials: L
authors.lastname: Tarivonda
keywords: Vanuatu; children; older adults; treatment outcomes; tuberculosis