<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_abm-2019-0004_s_004_w2aab3b7b3b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Elderly patients with pulmonary tuberculosis are less likely to achieve treatment success than younger patients, and patients aged ≥60 years have a substantial increase in mortality.</p></sec><sec id="j_abm-2019-0004_s_005_w2aab3b7b3b1b6b1aab1c16b2Aa"><h3>Objectives</h3><p>To compare treatment outcomes over 2 periods during the transition of Thai national tuberculosis (TB) reporting systems and determine treatment success rates and mortality for elderly patients in TB treatment-care settings in Thailand.</p></sec><sec id="j_abm-2019-0004_s_006_w2aab3b7b3b1b6b1aab1c16b3Aa"><h3>Methods</h3><p>Retrospective cohort study of all records of elderly patients extracted from 2 national TB databases in Thailand: the TB Case Management (TBCM) database of the National TB Program (2014–2015) and the database of the National Health Security Office (NHSO; 2010–2011).</p></sec><sec id="j_abm-2019-0004_s_007_w2aab3b7b3b1b6b1aab1c16b4Aa"><h3>Results</h3><p>There were 8,301 elderly patients with TB in the TBCM cohort and 11,869 in the NHSO cohort. Overall treatment success rates were 78.5% for patients in the TBCM cohort and 87.5% for patients in the NHSO cohort. High success rates for treatment were found for those aged 60–69 years: 91.1% in 2010–2011 and 85.0% in 2014–2015. High mortality was reported for patients aged ≥90 years: 34.6% in 2010–2011 and 50.0% in 2014–2015.</p></sec><sec id="j_abm-2019-0004_s_008_w2aab3b7b3b1b6b1aab1c16b5Aa"><h3>Conclusions</h3><p>Compared with the NHSO historical cohort, success rates for treatment were lower and death rates were higher in the TBCM cohort. Because NHSO enforced intensive case monitoring and follow-up while TBCM has no such mechanism, the estimates from the TBCM database may be less accurate for TB circumstances in Thailand. Frequent routine home visits may ensure more complete treatment-care information and support, and increase the treatment success rate in the elderly.</p></sec></abstract>

BackgroundElderly patients with pulmonary tuberculosis are less likely to achieve treatment success than younger patients, and patients aged ≥60 years have a substantial increase in mortality.ObjectivesTo compare treatment outcomes over 2 periods during the transition of Thai national tuberculosis (TB) reporting systems and determine treatment success rates and mortality for elderly patients in TB treatment-care settings in Thailand.MethodsRetrospective cohort study of all records of elderly patients extracted from 2 national TB databases in Thailand: the TB Case Management (TBCM) database of the National TB Program (2014–2015) and the database of the National Health Security Office (NHSO; 2010–2011).ResultsThere were 8,301 elderly patients with TB in the TBCM cohort and 11,869 in the NHSO cohort. Overall treatment success rates were 78.5% for patients in the TBCM cohort and 87.5% for patients in the NHSO cohort. High success rates for treatment were found for those aged 60–69 years: 91.1% in 2010–2011 and 85.0% in 2014–2015. High mortality was reported for patients aged ≥90 years: 34.6% in 2010–2011 and 50.0% in 2014–2015.ConclusionsCompared with the NHSO historical cohort, success rates for treatment were lower and death rates were higher in the TBCM cohort. Because NHSO enforced intensive case monitoring and follow-up while TBCM has no such mechanism, the estimates from the TBCM database may be less accurate for TB circumstances in Thailand. Frequent routine home visits may ensure more complete treatment-care information and support, and increase the treatment success rate in the elderly.

Treatment outcomes for elderly patients in Thailand with pulmonary tuberculosis

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

{"article-title":"Treatment outcomes for elderly patients in Thailand with pulmonary tuberculosis"}

BackgroundElderly patients with pulmonary tuberculosis are less likely to achieve treatment success than younger patients, and patients aged ≥60 years have a...

Variable	Total assessed, N	Success, n (%)	Nonsuccess, n (%)	RR, (95% CI)	aRR, (95% CI)
Year
2010–2011	11,869	10,388 (87.5)	1,481 (12.5)	1	1
2014–2015	8,301	6,519 (78.5)	1,782 (21.5)	0.90 (0.89–0.91)*	0.91 (0.90–0.92)*
Age group, y
60–69	10,109	8,943 (88.5)	1,166 (11.5)	1	1
70–79	6,898	5,719 (82.9)	1,179 (17.1)	0.94 (0.93–0.95)*	0.94 (0.93–0.95)*
80–89	2,913	2,110 (72.4)	803 (27.6)	0.82 (0.80–0.84)*	0.83 (0.81–0.85)*
90	250	135 (54.0)	115 (46.0)	0.61 (0.54–0.68)*	0.61 (0.55–0.68)*
Sex
Male	13,505	11,215 (83.0)	2,290 (17.0)	1	1
Female	6,636	5,673 (85.5)	963 (14.5)	1.03 (1.02–1.04)*	1.03 (1.02–1.04)*

Variable	Total assessed, N	Death, n (%)	Not death, n (%)	RR (0.95% CI)	aRR (0.95% CI)
Year
2010–2011	11,869	976 (8.2)	10,893 (91.8)	1	1
2014–2015	8,301	1,325 (16.0)	6,976 (84.0)	1.94 (1.80–2.10)*	2.01 (1.86–2.17)*
Age group, y
60–69	10,109	677 (6.7)	9,432 (93.3)	1	1
70–79	6,898	865 (12.5)	6,033 (87.5)	1.87 (1.70–2.06)*	1.95 (1.78–2.15)*
80–89	2,913	658 (22.6)	2,255 (77.4)	3.37 (3.05–3.72)*	3.58 (3.24–3.94)*
≥90	250	101 (40.4)	149 (59.6)	6.03 (5.10–7.13)*	6.19 (5.26–7.28)*
Sex
Male	13,505	1,612 (11.9)	11,893 (88.1)	1	1
Female	6,636	681 (10.3)	5,955 (89.7)	0.86 (0.79–0.94)*	0.78 (0.72–0.85)*

Treatment outcomes for elderly patients in Thailand with pulmonary tuberculosis

Article Category: Original article

Published Online: Apr 30, 2019

Page range: 75 - 82

DOI: https://doi.org/10.1515/abm-2019-0004

Keywords
aged, drug therapy, epidemiology, pulmonary, Thailand, tuberculosis

© 2018 Wilawan Somsong et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Figure 2

Factors associated with treatment success among elderly patients with PTB in Thailand, 2010–2011 and 2014–2015

Factors associated with death among elderly patients with PTB in Thailand, 2010–2011 and 2014–2015

Treatment outcomes for elderly patients in Thailand with pulmonary tuberculosis

Article Category: Original article

Published Online: Apr 30, 2019

Page range: 75 - 82

DOI: https://doi.org/10.1515/abm-2019-0004

Keywordsaged, drug therapy, epidemiology, pulmonary, Thailand, tuberculosis

© 2018 Wilawan Somsong et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Figure 2

Factors associated with treatment success among elderly patients with PTB in Thailand, 2010–2011 and 2014–2015

Factors associated with death among elderly patients with PTB in Thailand, 2010–2011 and 2014–2015

Keywords
aged, drug therapy, epidemiology, pulmonary, Thailand, tuberculosis