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    Apr 23, 2021
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    Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable?

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    Ncube et al - 2017 - Age-stratified ...
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    Authors
    Ncube, RT
    Takarinda, KC
    Zishiri, C
    van den Boogaard, W
    Mlilo, N
    Chiteve, C
    Siziba, N
    Trinchán, F
    Sandy, C
    Issue Date
    2017-09-21
    Submitted date
    2018-05-16
    
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    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
    URI
    http://hdl.handle.net/10144/619131
    DOI
    10.5588/pha.17.0024
    PubMed ID
    29201656
    Language
    en
    ISSN
    2220-8372
    ae974a485f413a2113503eed53cd6c53
    10.5588/pha.17.0024
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