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Tuberculosis annual report 2010--(4) Tuberculosis in the elderly
Ist Teil von
Kekkaku, 2012-09, Vol.87 (9), p.585
Ort / Verlag
Japan
Erscheinungsjahr
2012
Quelle
MEDLINE
Beschreibungen/Notizen
Since 1999, the notification rates among tuberculosis (TB) patients aged 85 years or above in Japan have been consistently higher than those of patients belonging to other age groups. The annual rates of reduction in age-specific TB notifications were similar among elderly patients (defined as those aged 65 years and above) until the mid-1990s; however, since 2000, the reduction rate in patients aged 65-79 years has accelerated. The proportion of elderly TB patients has increased 1.6 times, from 36.8% in 1987 to 59.1% in 2010, and the proportion of TB patients aged 80 years or older has increased 3.8 times, from 7.9% to 29.7% during the same period. The rate of bacteriologically positive TB among pulmonary TB (PTB) patients was higher in the elderly than in patients aged 15-64 years (referred to as "young adults"). The proportion of PTB patients with only non-respiratory symptoms increased with age: 16.2% in patients aged 65-74 years, 20.1% in those aged 75-84 years, and 23.6% in those 85 years and older. The proportion of TB cases in the elderly where patient delay was > or = 2 months was approximately twice less than that in young adults (13.8% vs. 25.9%), whereas the proportion of TB cases in elderly patients where doctor delay was > or = 1 month was slightly higher than that for young adults (24.2% vs. 20.0%). The elderly PTB patients tended to be diagnosed with TB when they were treated as outpatients or inpatients for diseases other than TB. Of the newly notified TB patients in 2009, 27.6% died within a year of initiation of TB treatment; of these, 15.9% died within 3 months. The proportion of deaths within 3 months after the initiation of therapy showed substantial increase with age.