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Trigui M, Ben Ayed H, Koubaa M, Ben Hmida M, Ben Jmaa M, Yaich S, Ben Jmaa T, Hammami F, Fki H, Damak J, Ben Jemaa M. Tuberculosis in elderly: Epidemiological profile, prognosis factors and chronological trends in Southern Tunisia, 1995-2016. J Infect Prev 2022; 23:255-262. [PMID: 36277862 PMCID: PMC9583438 DOI: 10.1177/17571774221127540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 07/22/2021] [Accepted: 06/13/2022] [Indexed: 11/03/2023] Open
Abstract
Background Tuberculosis (TB) has become a public health problem among elderly in developing countries with the gradual increase in life expectancy. Aim/Objective This study aimed to analyze the prognosis factors and chronological trends of TB in elderly in Southern Tunisia. Methods A retrospective study was conducted. All TB patients aged ≥60 years, recorded in the Center of TB Control between 1995 and 2016, were included. Chronological trends of TB were analyzed by calculating the correlation coefficient of Spearman (Rho). Multivariate analysis was done by binary logistic regression (Adjusted Odds ratio (AOR); CI; p) to determine the independent risk factors associated with unsuccessful outcome in elderly. A p value <0.05 was considered as statistically significant. Results Overall, 512 new elderly TB cases were notified between 1995 and 2016, with an average of 23.3 new cases/year. The mean TB incidence rate for elderly was 2.31/100,000 population/year. The case-fatality rate of 8.6%. Multivariate analysis showed that factors independently associated with unsuccessful outcome among elderly patients were age between 80 and 89 (AOR = 4.5; [95% CI: 2, 10.2]; p < 0.001), male gender (AOR = 2.2; [95% CI: 1.1, 4.4]; p = 0.026) and neuro-meningeal involvement (AOR = 4.6; [95% CI: 1.4, 14.8]; p = 0.011). The incidence of TB in elderly patients increased significantly from 0.95/100,000 population in 1995 to 2.17/100,000 population in 2016 (Rho = 0.48; p = 0.024). Discussion A better understanding of TB features in elderly and its chronological trends overtime would facilitate to put in place, in the national TB control program, strategies geared towards this group of people.
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Affiliation(s)
- Maroua Trigui
- Department of Community Health and
Epidemiology, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
- Extra-pulmonary Tuberculosis Research
Unity, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Houda Ben Ayed
- Extra-pulmonary Tuberculosis Research
Unity, Hedi Chaker University Hospital, Sfax, Tunisia
- Department of Preventive Medicine and Hospital
Hygiene, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Makram Koubaa
- Extra-pulmonary Tuberculosis Research
Unity, Hedi Chaker University Hospital, Sfax, Tunisia
- Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Mariem Ben Hmida
- Department of Community Health and
Epidemiology, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
- Extra-pulmonary Tuberculosis Research
Unity, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Maissa Ben Jmaa
- Extra-pulmonary Tuberculosis Research
Unity, Hedi Chaker University Hospital, Sfax, Tunisia
- Department of Preventive Medicine and Hospital
Hygiene, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Sourour Yaich
- Department of Community Health and
Epidemiology, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Tarek Ben Jmaa
- Extra-pulmonary Tuberculosis Research
Unity, Hedi Chaker University Hospital, Sfax, Tunisia
- Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Fatma Hammami
- Extra-pulmonary Tuberculosis Research
Unity, Hedi Chaker University Hospital, Sfax, Tunisia
- Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Habib Fki
- Department of Preventive Medicine and Hospital
Hygiene, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Jamel Damak
- Department of Community Health and
Epidemiology, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Mounir Ben Jemaa
- Extra-pulmonary Tuberculosis Research
Unity, Hedi Chaker University Hospital, Sfax, Tunisia
- Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
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Stosic M, Grujicic SS, Grgurevic A, Kuruc V, Ristic L, Antonijevic G, Jevtic M, Plavsa D, Vukicevic TA. Trends in tuberculosis notification and mortality and factors associated with treatment outcomes in Serbia, 2005 to 2015. Euro Surveill 2020; 25. [PMID: 31937395 PMCID: PMC6961260 DOI: 10.2807/1560-7917.es.2020.25.1.1900322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Previously a country with medium tuberculosis (TB) burden, Serbia almost reached a low TB burden during the period 2005 to 2015. Aim The aim of this study was to analyse the trends in notification rates and treatment success rates as well as to identify predictors of treatment outcomes. Methods We performed a trend analysis and logistic regression analysis of 17,441 TB cases registered from 2005 to 2015 in all health facilities in Serbia, to identify predictors of treatment success, loss to follow-up and mortality. Results From 2005 to 2015, TB notification rate and mortality in Serbia decreased but treatment success remained below the global target. Loss to follow-up was associated with retreatment (odds ratio (OR) = 2.38; 95% confidence interval (CI): 2.08–2.77), male sex (OR = 1.57; 95% CI: 1.39–1.79), age younger than 65 years (OR = 1.37; 95% CI: 1.20–1.51), lower education level (OR = 2.57; 95% CI: 1.74–3.80) and pulmonary TB (OR = 1.28; 95% CI: 1.06–1.56). Deaths were more frequent in retreatment cases (OR = 1.39; 95% CI: 1.12–1.61), male patients (OR = 1.34; 95% CI: 1.19–1.52), those 65 years and older (OR = 4.34; 95% CI: 4.00–5.00), those with lower education level (OR = 1.63; 95% CI: 1.14–2.33) and pulmonary TB (OR = 2.24; 95% CI: 1.78–2.83). Conclusions Special interventions should be implemented to address groups at risk of poor treatment outcome.
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Affiliation(s)
- Maja Stosic
- Public Health Institute of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Serbia
| | | | - Anita Grgurevic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vesna Kuruc
- Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - Lidija Ristic
- Clinic for Pulmonary Diseases, Clinical Center Nis, Nis, Serbia
| | | | - Miroslav Jevtic
- Special Hospital for Pulmonary Diseases Ozren-Sokobanja, Sokobanja, Serbia
| | - Dragana Plavsa
- Public Health Institute of Serbia “Dr Milan Jovanovic Batut”, Belgrade, Serbia
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Shokri M, Najafi R, Niromand J, Babazadeh A, Javanian M, Bayani M, Afra ZG, Ebrahimpour S. The frequency of risk factors for pulmonary tuberculosis in tuberculosis patients in Babol, Northern Iran, during 2008-2015. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2018. [DOI: 10.1515/cipms-2018-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
In the current study, we investigated the risk factors for tuberculosis in patients admitted to the Ayatollah Rouhani Hospital in Babol, north of Iran. This cross-sectional study was conducted on 207 patients with proven tuberculosis during the years 2008-2015. Demographic data such as age and sex, smoking, history of underlying illness, illness symptoms, and laboratory results were collected and analyzed at a significant level of less than 0.05. From 207 patients, 136 were male (65.7%), 71 were female (34.3%), and 76 of them (37.3%) were smokers. It is notable that most patients (29.5%) were over the age of 71. The relation between age profile and being tuberculosis has been studied, but the co-relation was found to be not significant. The most common complaint has been coughing (60.9%).
While investigating underling diseases, the most common illness has found to be Diabetes (11.3%). Based our finding, there was a significant relationship between gender and smoking with tuberculosis. Accordingly, as smoking is one of the risk factors for tuberculosis, smokers and non-smokers should be informed that smoking carries the risk for tuberculosis. Such a program should be particularly addressed to males.
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Affiliation(s)
- Mehran Shokri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , I.R. Iran
| | - Rahmatollah Najafi
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , I.R. Iran
| | - Jalal Niromand
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , I.R. Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , I.R. Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , I.R. Iran
| | - Masomeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , I.R. Iran
| | - Zahra Geraili Afra
- Department of Statistic and Epidmiology, School of Medicine , Babol University of Medical Sciences , Babol , I.R Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute , Babol University of Medical Sciences , Babol , I.R. Iran
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Gender disparities in mortality from infectious diseases in Serbia, 1991-2014: a time of civil wars and global crisis. Epidemiol Infect 2017; 144:2473-84. [PMID: 27483375 DOI: 10.1017/s0950268816001345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Infectious diseases remain one of the leading causes of death worldwide. The aim of this descriptive epidemiological study was to analyse the trends in mortality from infectious diseases in Serbia (excluding the Autonomous Province of Kosovo & Metohia) from 1991 to 2014 using joinpoint regression analysis. The mortality rates from infectious diseases were found to have increased markedly from 1991 to 1994 (+12·4% per year), followed by a significant decline from 1994 to 2009 (-4·6% per year) and then another increase from 2009 to 2014 (+4·3% per year). Throughout the study period, mortality rates were consistently higher in men than in women. Although a substantial decline was observed for young people of both sexes, no consistent pattern was evident for the middle-aged nor the elderly. Since 1991, septicaemia has emerged as a leading cause of infectious disease mortality, particularly in older men. The Yugoslav civil wars in the 1990s and the global financial crisis in 2008 corresponded with changes in the trends in mortality from infectious diseases in Serbia, with the elderly showing particular vulnerability during those time periods. Data presented in this study might be useful to improve control of infectious diseases in Serbia.
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de Oliveira AAV, de Sá LD, Nogueira JDA, de Andrade SLE, Palha PF, Villa TCS. [Tuberculosis diagnosis in the aged: barriers to accessing health services]. Rev Esc Enferm USP 2013; 47:145-51. [PMID: 23515814 DOI: 10.1590/s0080-62342013000100018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 07/09/2012] [Indexed: 11/22/2022] Open
Abstract
This study was performed with the objective to analyze the barriers to diagnosing tuberculosis in the aged and access to health services in the city of João Pessoa, Paraíba, Brazil. This qualitative study included the participation of seven aged women with tuberculosis. Interviews were used for data collection. The empirical material was organized using Atlas.ti 6.0, and analyzed according to the techniques of discourse analysis. The identified barriers related to the access to health services to confirm the diagnosis were: the operating hours of family health units; transferred responsibilities; home visits without controlling communicants; delay of the health service in suspecting the disease and the patient's repeated visits to the health center before being informed about the diagnosis. Despite the identification of common barriers that tuberculosis patients of all ages must deal with, because of the vulnerability of the elderly, health services should implement control actions so as to prevent the disease becoming a common condition in this population.
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Carvalho ACC, Migliori GB, Cirillo DM. Tuberculosis in Europe: a problem of drug resistance or much more? Expert Rev Respir Med 2010; 4:189-200. [PMID: 20406085 DOI: 10.1586/ers.10.7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tuberculosis has re-emerged as a public health concern in high-income countries in the last few decades. The European region accounts for only 5% of world TB cases. The incidence of new TB cases in Europe varies from very low rates in Scandinavian countries (six to eight cases/100,000 population) to rates as high as 231 cases/100,000 population in Tajikistan; the Russian Federation is eleventh among the 22 high-burden TB countries. The estimated detection rate of new sputum smear-positive pulmonary cases and the treatment success rate in 2007 were poor compared with other WHO regions: 51% of cases were diagnosed and 70% of them completed a full course of anti-TB therapy, which is still a long way from the World Health Assembly targets (detection of 70% of infectious cases and successful treatment of 85% of them). The low success rate is largely attributable to the increasing number of drug-resistant TB cases: Eastern European countries are among those with the highest rates of multidrug-resistant (MDR)-TB (TB resistant to rifampicin and isoniazid) in the world. By the end of September 2009, at least one case of extensively drug-resistant TB (named XDR-TB and defined as a MDR-TB strain with additional resistance to any fluoroquinolone, and to at least one of three injectable drugs used in anti-TB treatment) had been reported by 25 countries in the WHO European Region. In Western Europe, TB continues to cause disease among elderly native-born individuals, although high-risk groups including immigrants, prisoners, HIV-infected persons and drug addicts significantly contribute to the overall burden. Improved TB control in Europe requires a large coordinated effort by all stakeholders, including governments, governmental and non-governmental institutions, as well as the academic and private sectors and affected communities.
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Affiliation(s)
- Anna C C Carvalho
- Institute of Infectious and Tropical Diseases, Università degli Studi di Brescia, Piazzale Spedali Civili 1, 25125 Brescia, Italy
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Abstract
INTRODUCTION Tuberculous (TB) synovitis is a rare, treatable, potentially lethal form of extrapulmonary TB resulting from massive lymphohematogenous dissemination of Mycobacterium tuberculosis (M. tuberculosis). We presented a case of TB synovitis of the knee in a Caucasian HIV-negative man from Romania, a high TB incidence country. CASE REPORT A 65-year old man presented with cough, high fever, mild wheezing, and swelling of the left knee. Chest radiography was normal. Sputum smears were Acid Fast Bacilli negative and Lowenstein-Jensen (L-J) culture negative for M. tuberculosis. Tuberculin skin test was negative. Respiratory symptoms disappeared in a week under antibiotics. Positive L-J cultures of knee punctation and favourable treatment outcome following standardized antituberculous treatment regimen confirmed the diagnosis of specific synovitis, which was also demonstrated by Magnetic Resonance Imaging (MRI). CONCLUSION Tuberculous synovitis is important differencial diagnosis in patients with arthropathies and risk factors for TB in all the countries and all patients' ages even when tuberculin skin test is negative.
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A preliminary cross-national study of a possible relationship between elderly suicide rates and tuberculosis. Int Psychogeriatr 2009; 21:1190-5. [PMID: 19497140 DOI: 10.1017/s1041610209990378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The elderly are at high risk of developing tuberculosis. The prevalence and incidence of depression and anxiety are higher in those with tuberculosis than in the general population. A positive correlation between national suicide rates and rates of mortality due to tuberculosis has been reported. METHODS The relationships between elderly suicide rates and (i) the prevalence of tuberculosis, (ii) the proportion of detected cases of tuberculosis, and (iii) the proportion of cured cases of tuberculosis were examined in a cross-national study using data from the World Health Organization and the United Nations. RESULTS There were no significant correlations between elderly suicide rates and the prevalence of tuberculosis and the proportion of detected cases of tuberculosis. There were weak but significant negative correlations between the proportion of cured cases of tuberculosis and suicide rates for both sexes in both elderly age-bands. CONCLUSION Caution should be exercised in interpreting the findings and the direction of the causal relationship from this cross-sectional ecological study because of ecological fallacy. However, if the findings are true then potentially the study has important implications for prevention of elderly suicides, particularly in countries with a high prevalence of tuberculosis.
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Lönnroth K, Jaramillo E, Williams BG, Dye C, Raviglione M. Drivers of tuberculosis epidemics: The role of risk factors and social determinants. Soc Sci Med 2009; 68:2240-6. [DOI: 10.1016/j.socscimed.2009.03.041] [Citation(s) in RCA: 558] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Indexed: 11/17/2022]
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