Tuberculosis Presentation and Outcomes in Older Hispanic Adults From Tamaulipas, Mexico

Authors

Belinda A Medrano
Miryoung Lee
Gretchen Gemeinhardt
Javier E Rodríguez-Herrera
Moncerrato García-Viveros
Blanca I Restrepo

Publication Date

10-13-2023

Journal

Medicine

Abstract

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.

Keywords

Aged, Humans, Middle Aged, Cross-Sectional Studies, Hispanic or Latino, Latent Tuberculosis, Mexico, Tuberculosis, Adolescent, Young Adult, Adult, Tuberculosis, Pulmonary, BMI, death, diabetes, gerontology, Hispanics, older adults, older people, social support, TB, treatment outcomes, tuberculosis

DOI

10.1097/MD.0000000000035458

PMID

37832052

PMCID

PMC10578661

PubMedCentral® Posted Date

10-13-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes