A prospective study of pulmonary tuberculosis in rural geriatric population of South India

Background: Sparse data are available documenting similarities and differences in the clinical, bacteriological and radiographic features of pulmonary tuberculosis (TB) in persons aged over 60 years and those aged under 60 years. Materials and Methods: We prospectively studied 100 adult patients with pulmonary TB aged 18-59 years (n=50) and 60 years and above (n=50; elderly subjects) who presented to the medicine out-patient service and were admitted in the medical wards at our medical college teaching hospital at Kuppam, Andhra Pradesh. Results: In both the groups, males were in the majority (72% in geriatric and 60% in adult group). Hemoptysis (26% in geriatric and 42% in adult) and night sweats (12% in geriatric and 58% in adult) were frequent in adults than geriatric patients. Chronic obstructive pulmonary disease(COPD),Hypertension and diabetes mellitus were more frequent in geriatric patients than 18-59 year old adults. Cavitations were more common in adults, whereas lower lobe involvement was more frequent in the geriatric group. In the geriatric patients 72% were completely cured compared to 92% in adult patients. Treatment failure was 20% in geriatric group compared to 6% in adults. Mortality was 8% in geriatric and 2% in adults. Adverse reactions were frequent in geriatric group (n=20) than 18-59 year old individuals. Conclusion: The present study documents important differences in clinical and radiological presentation of pulmonary TB in geriatric patients compared with adults aged 18-59 years. Geriatric patients also experienced more frequent occurrence of adverse reactions, failure of treatment and mortality.