Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable?

Hdl Handle:
http://hdl.handle.net/10144/619131
Title:
Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable?
Authors:
Ncube, RT; Takarinda, KC; Zishiri, C; van den Boogaard, W; Mlilo, N; Chiteve, C; Siziba, N; Trinchán, F; Sandy, C
Journal:
Public Health Action
Abstract:
Setting: A high tuberculosis (TB) incidence, resource-limited urban setting in Zimbabwe. Objectives: To compare treatment outcomes among people initiated on first-line anti-tuberculosis treatment in relation to age and other explanatory factors. Design: This was a retrospective record review of routine programme data. Results: Of 2209 patients included in the study, 133 (6%) were children (aged <10 years), 132 (6%) adolescents (10-19 years), 1782 (81%) adults (20-59 years) and 162 (7%) were aged ⩾60 years, defined as elderly. The highest proportion of smear-negative pulmonary TB cases was among the elderly (40%). Unfavourable outcomes, mainly deaths, increased proportionately with age, and were highest among the elderly (adjusted relative risk 3.8, 95%CI 1.3-10.7). Having previous TB, being human immunodeficiency virus positive and not on antiretroviral treatment or cotrimoxazole preventive therapy were associated with an increased risk of unfavourable outcomes. Conclusion: The elderly had the worst outcomes among all the age groups. This may be related to immunosuppressant comorbidities or other age-related diseases mis-classified as TB, as a significant proportion were smear-negative. Older persons need better adapted TB management and more sensitive diagnostic tools, such as Xpert® MTB/RIF.
Publisher:
International Union Against Tuberculosis and Lung Disease
Issue Date:
21-Sep-2017
URI:
http://hdl.handle.net/10144/619131
DOI:
10.5588/pha.17.0024
PubMed ID:
29201656
Submitted date:
2018-05-16
Language:
en
ISSN:
2220-8372
Appears in Collections:
Operational Research Courses

Full metadata record

DC FieldValue Language
dc.contributor.authorNcube, RTen
dc.contributor.authorTakarinda, KCen
dc.contributor.authorZishiri, Cen
dc.contributor.authorvan den Boogaard, Wen
dc.contributor.authorMlilo, Nen
dc.contributor.authorChiteve, Cen
dc.contributor.authorSiziba, Nen
dc.contributor.authorTrinchán, Fen
dc.contributor.authorSandy, Cen
dc.date.accessioned2018-05-17T14:11:42Z-
dc.date.available2018-05-17T14:11:42Z-
dc.date.issued2017-09-21-
dc.date.submitted2018-05-16-
dc.identifier.citationAge-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable? 2017, 7 (3):212-217 Public Health Actionen
dc.identifier.issn2220-8372-
dc.identifier.pmid29201656-
dc.identifier.doi10.5588/pha.17.0024-
dc.identifier.urihttp://hdl.handle.net/10144/619131-
dc.description.abstractSetting: A high tuberculosis (TB) incidence, resource-limited urban setting in Zimbabwe. Objectives: To compare treatment outcomes among people initiated on first-line anti-tuberculosis treatment in relation to age and other explanatory factors. Design: This was a retrospective record review of routine programme data. Results: Of 2209 patients included in the study, 133 (6%) were children (aged <10 years), 132 (6%) adolescents (10-19 years), 1782 (81%) adults (20-59 years) and 162 (7%) were aged ⩾60 years, defined as elderly. The highest proportion of smear-negative pulmonary TB cases was among the elderly (40%). Unfavourable outcomes, mainly deaths, increased proportionately with age, and were highest among the elderly (adjusted relative risk 3.8, 95%CI 1.3-10.7). Having previous TB, being human immunodeficiency virus positive and not on antiretroviral treatment or cotrimoxazole preventive therapy were associated with an increased risk of unfavourable outcomes. Conclusion: The elderly had the worst outcomes among all the age groups. This may be related to immunosuppressant comorbidities or other age-related diseases mis-classified as TB, as a significant proportion were smear-negative. Older persons need better adapted TB management and more sensitive diagnostic tools, such as Xpert® MTB/RIF.en
dc.language.isoenen
dc.publisherInternational Union Against Tuberculosis and Lung Diseaseen
dc.rightsArchived with thanks to Public Health Actionen
dc.titleAge-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable?en
dc.identifier.journalPublic Health Actionen

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