Clinical Profile of Thoracic Tuberculosis among Elderly Population

Abstract

OBJECTIVE Tuberculosis is emerging as a significant health problem in the elderly. The symptoms are often non-specific and may be attributed to changes related to age. This often leads to a delayed diagnosis and more advanced disease at presentation. The presence of other underlying diseases may also alter the clinical picture. The aim of the study was to assess clinical, radiological and laboratory manifestations of tuberculosis in elderly patients. METHODOLOGY This cross sectional study was conducted among inpatients in geriatric medicine department and thoracic medicine department in a tertiary care hospital based on their inclusion and exclusion criteria. This study included 60 elderly patients aged more than 60 years from either sex. Detailed history regarding demographic pattern, associated factors and clinical presentations were elicited. Clinical, radiological and various laboratory parameters were analysed and tabulated. RESULTS Among the study population , 80 percent were male and 20 percent were female. Tuberculosis was common among rural population (50 percent), when compared with urban and semiurban population in our study due to varied health seeking behaviour. In our study population, 56.6 percent males and 13.3 percent females were aged 60-69 years, which was higher when compared with other age groups 70-79, 80 years.Smoking (73.3 percent) and alcohol (70 percent) contributed major associated factors followed by malnutrition (40 percent) and diabetes mellitus (36.6 percent).Elderly patients presented more with constitutional symptoms rather than respiratory symptoms in our study population.70 percent of patients had pulmonary tuberculosis and 30 percent of patients had extrapulmonary involvement. CONCLUSION The presentation of tuberculosis in elderly patients differs from that of younger patients by the predominance of constitutional rather than respiratory symptoms. Hence a high index of suspicion is required to make a timely diagnosis of tuberculosis in elderly.