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Tuberculosis incidence in elderly in Serbia: key trends in socioeconomic transition.

AIM
To examine tuberculosis incidence rates among the elderly in Central Serbia in 1992-2006 period, which was characterized by socioeconomic crisis and migration of population.


METHODS
We analyzed all reported active tuberculosis cases in a 15-year period, especially among patients aged > or =65, according to the Annual Reports of the Institute of Lung Diseases and Tuberculosis in Belgrade and Central Tuberculosis Register. Population estimates with extrapolations were based on 1991 and 2002 census data.


RESULTS
Total tuberculosis incidence rates showed a slight but non-significant decreasing trend (P=0.535), and no significant increase was found in patients aged > or =65 years (P=0.064), with an average age-specific incidence rate for the elderly of 64.0 (95% confidence interval, 60.7-67.4). The increase was significant in patients aged > or =70 years (y=49.3549+2.1186x; P=0.001), both in men (y=62.8666+2.3977x; P=0.005) and even more prominently in women (y=39.8240+1.9150x; P<0.001). The proportion of tuberculosis cases in the elderly peaked in 2005, with 35% of all tuberculosis cases.


CONCLUSION
High incidence rates and increasing time trend of tuberculosis in the elderly in Central Serbia is a serious problem, especially among those aged 70 years and over, who might present a target group for active case-finding of the disease.