Tuberculosis in elderly: Epidemiological profile, prognosis factors and chronological trends in Southern Tunisia, 1995-2016

Maroua Trigui; Houda Ben Ayed; Makram Koubaa; Mariem Ben Hmida; Maissa Ben Jmaa; Sourour Yaich; Tarek Ben Jmaa; Fatma Hammami; Habib Fki; Jamel Damak; Mounir Ben Jemaa

doi:10.1177/17571774221127540

Tuberculosis in elderly: Epidemiological profile, prognosis factors and chronological trends in Southern Tunisia, 1995-2016

J Infect Prev. 2022 Nov;23(6):255-262. doi: 10.1177/17571774221127540. Epub 2022 Sep 15.

Authors

Maroua Trigui^{1

2}, Houda Ben Ayed^{2

3}, Makram Koubaa^{2

4}, Mariem Ben Hmida^{1

2}, Maissa Ben Jmaa^{2

3}, Sourour Yaich¹, Tarek Ben Jmaa^{2

4}, Fatma Hammami^{2

4}, Habib Fki³, Jamel Damak¹, Mounir Ben Jemaa^{2

4}

Affiliations

¹ Department of Community Health and Epidemiology, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.
² Extra-pulmonary Tuberculosis Research Unity, Hedi Chaker University Hospital, Sfax, Tunisia.
³ Department of Preventive Medicine and Hospital Hygiene, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.
⁴ Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.

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.

Keywords: Tuberculosis; elderly; prognosis; trends.