Skip to content
Research Article Open access CC BY 4.0

Pulmonary Tuberculosis in the Elderly: Epidemiological, Clinical, and Evolutionary Aspects

Ngom N F, Mbaye B R, Ndiaye A, Thiam K., Faye F A, Dia Kane Y, Ka O, Coume M., Touré N O

Asian Journal of Research in Infectious Diseases · pp. 1–13 · Published 13 Apr 2024

10.9734/ajrid/2024/v15i4338

Abstract

Aims: this study aimed to investigate the epidemiological, clinical, and evolutionary aspects of pulmonary tuberculosis in the elderly and to determine the factors associated with death.  Study Design:  This was an exhaustive, descriptive, and analytical retrospective study. Place and Duration of Study: Pneumo-phtisiology department of Fann National Teaching Hospital Center over three years, from January 1, 2019, to December 31, 2021. Methodology: This was a study using medical records of patients aged 60 and over hospitalized in the pneumo-phtisiology department. Data were collected on a pre-established from patient medical records entered with Microsoft Excel 2019 software. Data analysis was performed with Statistical Package for Sciences Socials (SPSS) version 18 Results: we collected 620 medical records of hospitalized patients aged 60 and over, 69 of whom were diagnosed with pulmonary tuberculosis, standing for a prevalence of 11.12%. The average age was 67.13 [60;85] years, with a sex ratio of 3.92. The 60 to 65 age group was the most represented (n=36 or 52.17%). Smoking and alcoholism were frequent, 82% and 17.4% respectively. A previous history of TB infection was found in 23.19% of cases and TB contagion in 20.3% of cases. An underlying condition was at least observed in 50.72% of patients, dominated by diabetes (29%) and hypertension (23%). Co-infection with HIV-1 and tuberculosis was found in 2 patients (3%). The time to consultation was 75 days [3-180 days]. Symptomatology was polymorphic, dominated by cough (n=65; 94.20%), altered general condition (n=63; 91.30%), sputum (n=58; 84.06%), fever (n=53; 76.81%) and dyspnea (n=47; 68.12%). 46 patients (66.7%) had a BMI < 18.5 kg/m2. Physical signs were dominated by pulmonary condensation (n=52; 75.36%), and a fold of undernutrition was noted in 21.74% of cases. Microbiological evidence was 92.75% and 64 patients (92.75%) were susceptible to rifampin. A rifampin-resistant strain was detected in 5 patients (7.25%) hospitalized in the MDR-TB unit. CRP (75.36%), anemia (68.18%), hyperleukocytosis (47.7%), and hyponatremia (27.54%) were the most frequent biological signs. Alveolar syndrome (n=48 or 70%) and cavitary images (n=34 or 50%) were most frequently found on lung radiography, and for those who benefited from thoracic CT (n=36 or 52.17%), cavitary images were found in 24 cases (66.66%). Pulmonary embolism (n=9 cases, i.e. 40.9%), superinfection (n=4), and excessive hemoptysis (n=3) were the most frequent complications. The mean length of hospital stay was 17 days [3-58 days]. The 2RHZE/4RH protocol was used for 87%. Two patients were placed on a second-line anti-tuberculosis treatment protocol. Treatment was not specified in 7 patients (10.14%). The progression was favorable in 48 patients (69.56% of cases), with a case fatality rate of 30.44%.  Dyspnea, chest pain, anemia, hyperleukocytosis, and hyponatremia were associated with the risk of death. Conclusion: The elderly are particularly exposed to tuberculosis, due to physiological aging of the immune system and co-morbidities. This study highlighted the diagnostic and evolutionary particularities of pulmonary tuberculosis in the elderly, as well as the associated fatal factors.

Pulmonary tuberculosis Elderly Senegal

References (27)

  1. 1 Global tuberculosis report (2014)
  2. 2 Immunosenescence: emerging challenges for an ageing population [DOI]
  3. 3 Reported tuberculosis in the United States 2013
  4. 4 The aging lung: Physiology, disease, and immunity [DOI]
  5. 5 Tuberculosis and Aging: A Global Health Problem [DOI]
  6. 6 Tuberculosis among older adults – time to take notice [DOI]
  7. 7 Tuberculosis at extremes of age [DOI]
  8. 8 Does tuberculosis threaten our ageing populations? [DOI]
  9. 9 The impact of the COVID-19 epidemic on tuberculosis control in China [DOI]
  10. 10 Population aging and trends of pulmonary tuberculosis incidence in the elderly [DOI]
  11. 11 Active Pulmonary Tuberculosis in Elderly Patients: A 2016–2019 Retrospective Analysis from an Italian Referral Hospital [DOI]
  12. 12 Pulmonary Tuberculosis in Older Adults: Increased Mortality Related to Tuberculosis Within Two Months of Treatment Initiation [DOI]
  13. 13 Aging and Infectious Diseases in the Developing World [DOI]
  14. 14 Tuberculosis in ageing: high rates, complex diagnosis and poor clinical outcomes [DOI]
  15. 15 Risk factors for mortality among adult patients with newly diagnosed tuberculosis in Samara, Russia.
  16. 16 Clinical characteristics and treatment outcomes of tuberculosis in the elderly: a case control study [DOI]
  17. 17 Tuberculosis in Older People: A Retrospective and Comparative Study from Hong Kong [DOI]
  18. 18 Mortality among tuberculosis patients on treatment in Singapore.
  19. 19 Profile and Response to Anti-Tuberculosis Treatment among Elderly Tuberculosis Patients Treated under the TB Control Programme in South India [DOI]
  20. 20 Profile and Treatment Outcomes of Tuberculosis in the Elderly in Southeastern Nigeria, 2011–2012 [DOI]
  21. 21 Tuberculosis in the elderly in Germany: Table 1– [DOI]
  22. 22 Risk factors for early mortality in patients with pulmonary tuberculosis admitted to the emergency room [DOI]
  23. 23 Macrophages from elders are more permissive to intracellular multiplication of Mycobacterium tuberculosis [DOI]
  24. 24 Tuberculosis-related deaths in Queensland, Australia, 1989-1998: characteristics and risk factors.
  25. 25 Problems faced by tuberculosis patients during COVID-19 pandemic: Urgent need to intervene [DOI]
  26. 26 PULMONARY TUBERCULOSIS IN THE ELDERLY
  27. 27 THE PATHOGENESIS OF PULMONARY TUBERCULOSIS AMONG OLDER PERSONS. [DOI]

Cited by 0

No indexed citations yet.

Related research

Article metrics

Real usage data collected on this platform.

59

Page views

0

PDF downloads

18

Outbound clicks

0

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.