Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico.
Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico.
复制标题
DOI：
10.1097/md.0000000000035458
复制
发表时间：
2023-10-13
期刊：
影响因子：
1.6
通讯作者：
中科院分区：
文献类型：
--
作者：
老年人患肺结核（TB）等肺部感染和死亡的风险很高，但对他们的研究很少，特别是在西班牙裔美国人中。为了解决这些差距，我们试图通过对墨西哥塔毛利帕斯州（2006-2013年; n = 8381）的结核病监测数据进行横断面研究，确定与老年西班牙裔结核病和不良治疗结局相关的宿主因素。与年轻人（YA，18-39岁）和中年人（40-64岁）相比，评估了老年人（OA ≥65岁）的多变量logistic回归。我们发现OA具有与不太复杂的TB相关的特征（例如，肺外结核患病率较低，放弃治疗或患耐药结核的可能性较小），但在结核病治疗期间死亡的可能性较大（adj-OR 3.9，95% 2.5，5.25）。在OA患者中，过量饮酒和低体重指数增加了他们在结核病治疗期间的死亡几率，而报告的接触者（社会支持）的数量更高则具有保护作用。糖尿病与OA的不良结局无关。虽然年龄较大是结核病死亡的预测因素，但世界卫生组织在接触调查期间并没有优先考虑OA作为潜伏性结核感染筛查和治疗。随着更安全的短程潜伏性结核感染治疗的出现，我们建议将OA作为高危人群纳入潜伏性结核病管理指南。
Older people are at high risk of developing and dying from pulmonary infections like tuberculosis (TB), but there are few studies among them, particularly in Hispanics. To address these gaps, we sought to identify host factors associated with TB and adverse treatment outcomes in older Hispanics by conducting a cross-sectional study of TB surveillance data from Tamaulipas, Mexico (2006–2013; n = 8381). Multivariable logistic regressions were assessed for older adults (OA ≥65 years) when compared to young (YA, 18–39 years) and middle-aged adults (40–64 years). We found that the OA had features associated with a less complicated TB (e.g., lower prevalence of extra-pulmonary TB and less likely to abandon treatment or have drug resistant TB), and yet, were more likely to die during TB treatment (adj-OR 3.9, 95% 2.5, 5.25). Among the OA, excess alcohol use and low body mass index increased their odds of death during TB treatment, while a higher number of reported contacts (social support) was protective. Diabetes was not associated with adverse outcomes in OA. Although older age is a predictor of death during TB disease, OA are not prioritized by the World Health Organization for latent TB infection screening and treatment during contact investigations. With safer, short-course latent TB infection treatment available, we propose the inclusion of OA as a high-risk group in latent TB management guidelines.
影响因子：
5.8
作者：
Caylà JA;Rodrigo T;Ruiz-Manzano J;Caminero JA;Vidal R;García JM;Blanquer R;Casals M;Working Group on Completion of Tuberculosis Treatment in Spain (Study ECUTTE)
通讯作者：
Working Group on Completion of Tuberculosis Treatment in Spain (Study ECUTTE)
影响因子：
2.9
作者：
Giri VP;Giri OP;Pandey PT;Mishra KN;Prasad RS;Lal PK;Pratap R;Nikhil N;Sufian A;Ahmad R;Kanodia S
通讯作者：
Kanodia S