Analysis of treatment outcomes of elderly pulmonary tuberculosis aged 65 and above in Chongqing from 2015 to 2020 / 中国热带医学

@#Abstract: Objective　To analyze the treatment outcomes of elderly patients with pulmonary tuberculosis in Chongqing, so as to provide reference for the prevention and control strategies of the epidemic of elderly pulmonary tuberculosis. Methods　The data of tuberculosis cases aged ≥65 years in Chongqing from 2015 to 2020 were collected from the National Health Insurance Information Project Disease Prevention and Control Information system. Descriptive statistical methods were used to analyze the data. Results The registration rates of elderly active pulmonary tuberculosis patients and etiological positive patients were 110.95/10-5and 32.25/10-5 in 2015 and 84.06/10-5 and 57.29/10-5 in 2020. The annual decline rate of active tuberculosis registration was 5.40%, and the annual increase rate of pathogenic-positive tuberculosis registration was 12.18%. The registration rates of active tuberculosis patients and etiological positive patients in the whole population were 70.75/10-5 and 17.63/10-5 in 2015 and 50.34/10-5 and 29.14/10-5 in 2020. The annual decline rate of active tuberculosis registration was 6.58%, and the annual increase rate of pathogenic-positive tuberculosis registration was 10.57%. From 2015 to 2020, a total of 25 931 cases of elderly pulmonary tuberculosis were registered, of which 21 374 (82.43%) cases were successfully treated and 4 010 (15.80%) cases had unfavorable outcomes. The proportion of cured and death patients showed an increasing trend year by year (χ2trend=313.853, 100.502, P<0.01). From 2015 to 2020, the average annual successful treatment rate of elderly pulmonary tuberculosis in the whole city was 82.43%, with the lowest rate in southeast Chongqing (74.23%), followed by urban areas (81.99%). The success rate of elderly pulmonary tuberculosis treatment in the whole city, west Chongqing, northeast Chongqing and southeast Chongqing showed a downward trend year by year (χ2trend=230.199, 35.278, 108.076, 112.130, all P<0.01), with annual decline rates of 2.77%, 2.26%, 3.0% and 4.12%, respectively. Among the registered elderly patients, female, 65-<75 years old, Han nationality, newly diagnosed, no complications, and negative for etiology (χ2=15.234, 255.910, 146.842, 179.998, 25.575, 131.170, P<0.01) had higher success treatment rates. Conclusions The prevalence of pulmonary tuberculosis in the elderly population in Chongqing City is declining, but the positive registration rate of etiology is increasing annually, and the success rate of treatment is decreasing. Therefore, it is necessary to strengthen the systematic management, publicity and education of elderly patients (especially those in southeast Chongqing, male, positive patients and severe patients) to effectively control the epidemic of tuberculosis in the elderly.

Prevalence of tuberculosis in Faridabad district, Haryana State, India.

Background & objectives: Epidemiological information on tuberculosis (TB) has always been vital for planning control strategies. It has now gained further importance for monitoring the impact of interventions to control the disease. The present study was done to estimate the prevalence of bacillary tuberculosis in the district of Faridabad in Haryana State of India among persons aged older than 15 years. Methods: In this cross-sectional study, residents of Faridabad district were assessed for the prevalence of tuberculosis. Twelve rural and 24 urban clusters with estimated populations of 41,106 and 64,827 individuals were selected for the study. Two sputum samples were collected from individuals found eligible for inclusion. The samples were also cultured by modified Petroff’s method and were examined for growth of Mycobacterium tuberculosis once a week for eight weeks. A person found positive by smear and/or culture was identified as sputum-positive pulmonary TB positive. Results: A total of 105,202 subjects were enumerated in various clusters of the Faridabad district. There were 50,057 (47.58%) females and 55,145 (52.42%) males. Of these 98,599 (93.7%) were examined by the study group (47,976 females; 50,623 males). The overall prevalence of sputum smear or culture positive pulmonary tuberculosis in our study was found to be 101.4 per 100,000 population. Interpretation & conclusions: The present results showed that the prevalence of sputum positive pulmonary tuberculosis was higher in Faridabad district than the notification rates recorded by the World Health Organization for the contemporary period, a disparity that could be explained by a difference in case detection strategy employed for the study.

Chest Radiograhic Patterns of Smear Positive Tuberculosis in Relation to HIV: A Cross-Sectional Study in a Population with a High Burden of HIV and Tuberculosis.

Aim: The purpose of this study was to investigate the chest radiographic patterns of smear positive pulmonary tuberculosis patients in relation to HIV co-infection. Study Deign: Cross-sectional descriptive study Place and Duration of the Study: The study was conducted at Gondar University hospital between May 2004–December 2007. Methodology: We studied chest radiographs of 207 (128 HIV negative and 79 HIV positive) consecutive sputum smear positive pulmonary tuberculosis patients according to the standard classification. Mean and percentages/ proportions were used for descriptive analysis. Chi square test was used to measure association. Results: The prevalence of HIV in patients with smear positive pulmonary tuberculosis was 38.2%. The most common chest radiographic patterns were fibronodular (83.1%), cavity (60.4%), lobar consolidation (49.8%), and brochopnemonic consolidation (9.2%). Lymphadenopthy and pleural effusion were more common in HIV co infected patients (p<0.01). Cavities, upper lobe disease and increased mean number of lung lobes involved were more prominent in HIV negative patients (P<0.05). Despite a higher rate of patients with far advanced CXR patterns in HIV negative TBC patients compared to HIV positive (p<0.026), there was no significant difference in the radiographic, sputum smear conversion or clinical response in terms of increased body mass index after 8 weeks of anti TBC treatment between HIV negative and HIV positive patients. Conclusion: Post primary pulmonary tuberculosis was the commonest chest radiographic pattern at presentation in both HIV positive and HIV negative patients, but atypical chest radiographic presentations were associated with co-infection. It was more common for HIV negative tuberculosis patients to have a radiologically far advanced pattern which did not correspond to the clinical and radiological response. This may prompt a need for revision of the current radiological classification.