Tuberculosis at extremes of age
Date
2010
Authors
Schaaf H.S.
Collins A.
Bekker A.
Davies P.D.O.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Although tuberculosis (TB) has its highest burden among young adults, especially since the advent of HIV infection, two other groups with low immunity, the very young (<1 year) with immature immunity and the elderly (>65 years) with waning immunity, are vulnerable groups not to be forgotten. This review describes the epidemiology, clinical aspects, public health aspects and outcome of TB in patients at the extremes of age. The epidemiology differs therein that TB in infants occurs in developing countries with high incidences of TB and HIV, while TB in the elderly occurs in developed countries with ageing populations. The clinical presentation may be non-specific, history of contact with TB is often not known and TB is often not considered at these age extremes, and when the diagnosis is considered, disease progression may already be advanced. Anti-TB treatment regimens are the same as in other age groups, but drug dosages may need adjustment according to weight, renal function, liver function and other potentially complicating factors. Adverse events are more difficult to observe and both the young and the elderly are reliant on others for adherence to treatment. Mortality at both age extremes is higher than in the general TB population. For all the above reasons, public health measures to: prevent transmission of infection; identify those infected and providing preventive therapy; high index of suspicion in order to make an early diagnosis; and timely initiation of treatment are important in both the very young and the elderly. © 2010 The Authors.
Description
Keywords
acetohydrazide, antiretrovirus agent, cotrimoxazole, digoxin, ethambutol, ethionamide, gamma interferon, hydrazine, immunosuppressive agent, isoniazid, phenytoin, pyrazinamide, pyridoxine, rifampicin, streptomycin, abdominal distension, acid fast bacterium, aged, alcohol consumption, anorexia, apnea, ascites, BCG vaccination, blood flow, Brazil, chronic kidney disease, clinical feature, congenital tuberculosis, coughing, cyanosis, developed country, developing country, diabetes mellitus, directly observed therapy, disease course, disease predisposition, disease severity, disease transmission, DNA fingerprinting, dyspnea, early diagnosis, facial nerve paralysis, failure to thrive, fever, follow up, groups by age, health survey, hearing loss, hemoptysis, hepatomegaly, human, Human immunodeficiency virus, Human immunodeficiency virus prevalence, incidence, infant, infection control, infection prevention, infection risk, injection site abscess, irritability, jaundice, kidney function, liver dysfunction, liver function, liver toxicity, low birth weight, lung infiltrate, lung resection, lymphadenopathy, major clinical study, malnutrition, mastoiditis, MEDLINE, mental disease, mixed infection, monitoring, morbidity, mortality, Mycobacterium bovis, Mycobacterium tuberculosis, nonhuman, otorrhea, outcome assessment, papular rash, patient compliance, Pneumocystis jiroveci, Pneumocystis pneumonia, prematurity, priority journal, prophylaxis, public health, pustule, respiratory distress, review, screening, senescence, sepsis, shock, short course therapy, splenomegaly, stridor, tachypnea, thorax pain, thorax radiography, tuberculin test, tuberculosis, tuberculous meningitis, tuberculous osteomyelitis, urogenital tuberculosis, visual disorder, weakness, weight, weight reduction, wheezing, world health organization
Citation
Respirology
15
5
15
5