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Tuberculosis in elderly: The Indian perspective

Background: Tuberculosis, the leading infectious cause of morbidity, mortality worldwide. Elderly Tuberculosis accounts for a major proportion of these cases and are often neglected due to associated comorbidities and overlapping clinical features. This study aimed to estimate the prevalence of tuberculosis among elderly and medication adherence.Methods: A cross-sectional, retrospective study in patients with Tuberculosis ≥50 years registered under RNTCP, at a tertiary care hospital, South India, from January 2017 to December 2017. Clinical data collected, and medication adherence was assessed.Results: Out of the total 187 study population, 35 subjects were found to be ≥50 years with a prevalence of 18.7%. Pulmonary Tuberculosis was more common (82.8%). Majority of the subjects were sputum positive (77.14%). Comorbidities highest in patients >70years. Diabetes was the most significant comorbidity in all the age groups (48.57%) and patients with pulmonary Tuberculosis (p=0.04). Pulmonary Tuberculosis observed highest among smokers whereas extra pulmonary Tuberculosis found higher among alcoholics (33.3%). Treatment outcome was better in patients with hypertension compared to other comorbidities (p=0.014). Loss to follow-up was highest among smokers and in patients with bronchial asthma (40%). Present study showed moderate to low adherence to medication in elderly.Conclusions: There is high prevalence of Tuberculosis among elderly. Diabetes was the commonest comorbidity. Pulmonary Tuberculosis was significantly associated with smokers. Low adherence and loss to follow-up was high among elderly. We recommend comprehensive screening, treatment and follow-up especially in elderly with comorbidities for early diagnosis and better treatment outcome.  