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dc.contributor.authorNcube, RT
dc.contributor.authorTakarinda, KC
dc.contributor.authorZishiri, C
dc.contributor.authorvan den Boogaard, W
dc.contributor.authorMlilo, N
dc.contributor.authorChiteve, C
dc.contributor.authorSiziba, N
dc.contributor.authorTrinchán, F
dc.contributor.authorSandy, C
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.
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
refterms.dateFOA2019-03-04T13:54:06Z
html.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.


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