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Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico

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 c...

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Autores principales: Medrano, Belinda A., Lee, Miryoung, Gemeinhardt, Gretchen, Rodríguez-Herrera, Javier E., García-Viveros, Moncerrato, Restrepo, Blanca I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578661/
https://www.ncbi.nlm.nih.gov/pubmed/37832052
http://dx.doi.org/10.1097/MD.0000000000035458
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author Medrano, Belinda A.
Lee, Miryoung
Gemeinhardt, Gretchen
Rodríguez-Herrera, Javier E.
García-Viveros, Moncerrato
Restrepo, Blanca I.
author_facet Medrano, Belinda A.
Lee, Miryoung
Gemeinhardt, Gretchen
Rodríguez-Herrera, Javier E.
García-Viveros, Moncerrato
Restrepo, Blanca I.
author_sort Medrano, Belinda A.
collection PubMed
description 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.
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spelling pubmed-105786612023-10-17 Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico Medrano, Belinda A. Lee, Miryoung Gemeinhardt, Gretchen Rodríguez-Herrera, Javier E. García-Viveros, Moncerrato Restrepo, Blanca I. Medicine (Baltimore) Observational Study 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. Lippincott Williams & Wilkins 2023-10-13 /pmc/articles/PMC10578661/ /pubmed/37832052 http://dx.doi.org/10.1097/MD.0000000000035458 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Observational Study
Medrano, Belinda A.
Lee, Miryoung
Gemeinhardt, Gretchen
Rodríguez-Herrera, Javier E.
García-Viveros, Moncerrato
Restrepo, Blanca I.
Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico
title Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico
title_full Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico
title_fullStr Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico
title_full_unstemmed Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico
title_short Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico
title_sort tuberculosis presentation and outcomes in older hispanic adults from tamaulipas, mexico
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578661/
https://www.ncbi.nlm.nih.gov/pubmed/37832052
http://dx.doi.org/10.1097/MD.0000000000035458
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