PURPOSE: With an increase in life expectancy and the resultant elderly population, there has been an increase in the number of tuberculosis cases in the geriatric age. The study was conducted to observe the clinical profile and treatment outcome of elderly patients of tuberculosis treated under Directly Observed Treatment Short course (DOTS).
METHODS: 201 cases of tuberculosis above 50 years were included and divided in two groups; 50-65 years and>65 years. Diagnosis was made on the basis of detailed clinical history, physical-examination, sputum smear and chest radiographs. Pleural/Ascitic fluid analysis /FNAC done wherever required.
RESULTS: Of the 201 patients, 137 were males and 64 females. 161 were in 50-65 years group while 40 were >65 years. Majority of patients had Pulmonary disease (74.62%). Cough was observed in 72.13%, breathlessness (69.15%), weight-loss (67.16%), fever (53.73%). Sputum smear of AFB positive (54.23%), X-ray lesions (94.52%). Coexisiting morbidities were Diabetes mellitus (14.92%), COPD (9.45%) and Bronchogenic carcinoma (0.99%). Majority (55.72%) were given category I treatment. Treatment success rate (cure/completion) was 76.78%, 75% and 87.1% in Categories 1,2 and 3 respectively. Cure/completion rate in 50-65 years group was 81.98% and 70% in the >65 years group; the difference being statistically significant (p<0.05). Treatment default and mortality rates were 7.46% and 5.59% in 50-65 years group and 12.5% and 12.5% in > 65years group respectively.
CONCLUSION: Due to sociopsychological and medical aspects of ageing, comorbid states and misperception of symptoms, diagnosis of tuberculosis is difficult and delayed in elderly. A high index of suspicion, appropriate investigations and prompt institution of treatment will decrease the morbidity and mortality in such cases.
CLINICAL IMPLICATIONS: Increased awareness in disease recognition and better medical and social support are needed in addressing the problem of tuberculosis in older people.
DISCLOSURE: Nirmal Chand, No Financial Disclosure Information; No Product/Research Disclosure Information