Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda.
While old age is a known risk factor for developing active tuberculosis (TB), studies on TB in the population aged 60 years and older (considered elderly in this study) are few, especially in the developing world. Results of the TB prevalence survey in Uganda found high TB prevalence (570/100,000) i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0208390 |
| _version_ | 1818588933692325888 |
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| author | Nicholas Sebuliba Kirirabwa Derrick Kimuli Seyoum DeJene Carol Nanziri Estella Birabwa Daniel Ayen Okello Pedro Guillermo Suarez Samuel Kasozi Raymond Byaruhanga Deus Lukoye |
| author_facet | Nicholas Sebuliba Kirirabwa Derrick Kimuli Seyoum DeJene Carol Nanziri Estella Birabwa Daniel Ayen Okello Pedro Guillermo Suarez Samuel Kasozi Raymond Byaruhanga Deus Lukoye |
| author_sort | Nicholas Sebuliba Kirirabwa |
| collection | DOAJ |
| description | While old age is a known risk factor for developing active tuberculosis (TB), studies on TB in the population aged 60 years and older (considered elderly in this study) are few, especially in the developing world. Results of the TB prevalence survey in Uganda found high TB prevalence (570/100,000) in people over 65. We focused on treatment outcomes in the elderly to understand this epidemic better. We conducted a retrospective analysis of data from TB facility registers in Kampala City for the period 2014-2015. We analyzed the 2014-15 cohort with respect to age, sex, disease class, patients' human immunodeficiency virus (HIV) and directly observed therapy (DOT) status, type of facility, and treatment outcomes and compared findings in the elderly (≥60) and younger (<60) age groups. Of 15,429 records, 3.3% (514/15,429) were for elderly patients. The treatment success rate (TSR) among elderly TB patients (68.3%) was lower than that of the non-elderly (80.9%) and the overall TSR 80.5%, (12,417/15,429) in Kampala. Although the elderly were less likely to test positive for HIV than the young (AOR 0.39; 95% CI 0.33-0.48, p<0.001), they had a two-fold higher risk of unfavorable treatment outcomes (AOR 2.14; CI 1.84-2.72, p<0.001) and were more likely to die while on treatment (AOR 1.86; CI 1.27-2.73; p = 0.001). However, there was no statistically significantly difference between treatment outcomes among HIV-positive and HIV-negative elderly TB patients. Compared to the younger TB patients, elderly TB patients have markedly poorer treatment outcomes, although TB/HIV co-infection rates in this age group are lower. |
| first_indexed | 2024-12-16T09:32:38Z |
| format | Article |
| id | doaj.art-a213aa3a070741c6bc082d101339576b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T09:32:38Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-a213aa3a070741c6bc082d101339576b2022-12-21T22:36:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011312e020839010.1371/journal.pone.0208390Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda.Nicholas Sebuliba KirirabwaDerrick KimuliSeyoum DeJeneCarol NanziriEstella BirabwaDaniel Ayen OkelloPedro Guillermo SuarezSamuel KasoziRaymond ByaruhangaDeus LukoyeWhile old age is a known risk factor for developing active tuberculosis (TB), studies on TB in the population aged 60 years and older (considered elderly in this study) are few, especially in the developing world. Results of the TB prevalence survey in Uganda found high TB prevalence (570/100,000) in people over 65. We focused on treatment outcomes in the elderly to understand this epidemic better. We conducted a retrospective analysis of data from TB facility registers in Kampala City for the period 2014-2015. We analyzed the 2014-15 cohort with respect to age, sex, disease class, patients' human immunodeficiency virus (HIV) and directly observed therapy (DOT) status, type of facility, and treatment outcomes and compared findings in the elderly (≥60) and younger (<60) age groups. Of 15,429 records, 3.3% (514/15,429) were for elderly patients. The treatment success rate (TSR) among elderly TB patients (68.3%) was lower than that of the non-elderly (80.9%) and the overall TSR 80.5%, (12,417/15,429) in Kampala. Although the elderly were less likely to test positive for HIV than the young (AOR 0.39; 95% CI 0.33-0.48, p<0.001), they had a two-fold higher risk of unfavorable treatment outcomes (AOR 2.14; CI 1.84-2.72, p<0.001) and were more likely to die while on treatment (AOR 1.86; CI 1.27-2.73; p = 0.001). However, there was no statistically significantly difference between treatment outcomes among HIV-positive and HIV-negative elderly TB patients. Compared to the younger TB patients, elderly TB patients have markedly poorer treatment outcomes, although TB/HIV co-infection rates in this age group are lower.https://doi.org/10.1371/journal.pone.0208390 |
| spellingShingle | Nicholas Sebuliba Kirirabwa Derrick Kimuli Seyoum DeJene Carol Nanziri Estella Birabwa Daniel Ayen Okello Pedro Guillermo Suarez Samuel Kasozi Raymond Byaruhanga Deus Lukoye Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda. PLoS ONE |
| title | Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda. |
| title_full | Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda. |
| title_fullStr | Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda. |
| title_full_unstemmed | Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda. |
| title_short | Response to anti-tuberculosis treatment by people over age 60 in Kampala, Uganda. |
| title_sort | response to anti tuberculosis treatment by people over age 60 in kampala uganda |
| url | https://doi.org/10.1371/journal.pone.0208390 |
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