COMPARISON AND ANALYSIS OF CLINICAL PROFILE AND TREATMENT OUTCOME IN ELDERLY TB PATIENTS IN URBAN AND RURAL AREAS OF TAMILNADU -IMPLICATIONS IN MANAGEMENT

INTRODUCTIONS - India accounts for one fourth of TB cases of the world. Demographic transition has resulted in an increase in the elderly, and so also a higher TB burden in elderly, given the increased vulnerability. At present TB in the elderly contributes to 14 percentage of total TB cases. Elderly TB is complicated by factors like alcoholism, drug reactions and DM, cancer etc, Persistence of infection in this subgroup may be an important source infection and may perpetuate the pool of infection in the community. Hence, it is crucial to understand the clinical profile and factors affecting treatment outcome, since they have important implications in management. OBJECTIVE -To study the clinical profile in elderly patients and analyze the treatment outcomes and causes contributing to same in terms of association with comorbid illness, drug reactions and other factors. METHODOLOGY - Retrospective analysis of TB patients treated from 2011 to 2013 and study the clinical profile of elderly TB patients and analysis of treatment outcomes and contributory factors, comparing one urban based and one rural Tuberculosis UNIT. RESULTS - Majority of the patients were pulmonary though extrapulmonary cases were higher in urban than rural TU. Higher number of patients were smear negative in Urban than Rural, probably reflecting higher case detection due to better access to health services in Urban set up. Failure of Treatment and switch over to MDR was less (0.5), At the same time, Death rate was higher in Elderly 8.5 percentage compared to 6 percentage in Non Elderly population. Alcoholism and DM and cancer were main causes of poor outcome in Urban and Rural TUs. HIV was not a significant factor in the Elderly. CONCLUSION - TB in Elderly is a significant problem. Elderly TB can remain as a source, allowing. perpetuation of TB in the community. Hence, warrants special attention. A refined and dedicated system to record l the comorbities, Drug reactions is required .Collaboration of TB and Non Communicable Diseases programmes, especially DMcancer and cardiac diseases for comprehensive management is need of the hour.