School of Medicine Publications and Presentations
Document Type
Article
Publication Date
5-13-2024
Abstract
Pulmonary tuberculosis (PTB) elimination efforts must consider the global growth of the ageing population. Here we used TB surveillance data from Texas, United States (2008–2020; total n = 10656) to identify unique characteristics and outcomes in older adults (OA, ≥65 years) with PTB, compared to young adults (YA, 18–39 years) or middle-aged adults (40–64 years). We found that the proportion of OA with PTB increased from 15% in 2008 to 24% in 2020 (trend p < 0.05). Diabetes was highly prevalent in OA (32%) but not associated with adverse outcomes. Death was 13-fold higher in OA compared to YA and was 7% at the time of diagnosis which suggests diagnostic delays. However, once TB was suspected, we found no differences in culture, smear, or nucleic acid detection of mycobacteria (although less lung cavitations) in OA. During treatment, OA had less drug-resistant TB, few adverse reactions and adhered with TB treatment. We recommend training healthcare workers to ‘think TB’ in OA, for prompt treatment initiation to diminish deaths. Furthermore, OA should be added as a priority group to the latent TB treatment guidelines by the World Health Organization, to prevent TB disease in this highly vulnerable group.
Recommended Citation
Medrano, Belinda A., Miryoung Lee, Gretchen Gemeinhardt, Lana Yamba, and Blanca I. Restrepo. “High All-Cause Mortality and Increasing Proportion of Older Adults with Tuberculosis in Texas, 2008–2020.” Epidemiology and Infection 152 (2024): e82. https://doi.org/10.1017/S0950268824000669
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Publication Title
Epidemiology & Infection
DOI
10.1017/S0950268824000669
Academic Level
faculty
Comments
© The Author(s), 2024. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.