Profile and treatment outcomes of elderly patients with tuberculosis in Delhi, India: implications for their management

Given Indias high rate of TB, rising burden of non-communicable diseases (NCDs) and growing elderly population, elderly TB patients may be at higher risk of adverse outcomes including death, loss-to-follow-up (LTFU) and treatment failure. This may call for modifications in their management. This study thus aimed to compare the profile and treatment outcomes between elderly (60 years) and non-elderly (1559 years) TB patients. This was a retrospective cohort study using routinely-collected programme data from a chest clinic in Delhi, India. It included all elderly and selected non-elderly TB patients registered for treatment between 2005 and 2010. Data on patients clinical and demographic characteristics and treatment outcomes were analysed. There were 812 elderly and 1624 non-elderly TB patients. Elderly patients were more likely to be male (63.2 vs 51.1) and have smear-positive TB (56.0 vs 47.4). Adverse outcomes were more frequent among elderly patients (adjusted OR 1.9, 95 CI: 1.52.4), specifically deaths (adjusted OR 5.0, 95 CI: 3.18.1) and lost-to-follow-up (adjusted OR 1.4, 95 CI: 1.01.9). The profile and worse outcomes of elderly Indian TB patients may be indicative of co-existing NCDs. This needs further investigation and likely calls for a more comprehensive and intensive approach to their management.