Extra-Pulmonary and Pulmonary Tuberculosis among Elderly Peruvian Patients

Background: Tuberculosis (TB) is one of the main causes of mortality worldwide and in Peru, it represents a national health priority since >35 thousand people suffer from the disease annually. The aim of the study was to evaluate the frequency of extra-pulmonary (EPTB) and pulmonary Tuberculosis (PTB) among older patients (≥ 90 years old) during 2015-2017 in a poor district with a high-prevalence of TB in Lima, Peru.

Methods and findings: This cross-sectional study evaluated elderly patients of El Agustino district (population density of 15 416.19 hab/km²). The samples included were from the TB Control Program (PCT), from outpatient clinics, and patients over 90 years old of both sexes. All the extra pulmonary specimens (gastric aspirate, pleural fluid, etc.) were obtained in the respective services and were sent immediately for analysis. The culture medium for TB was Ogawa-Kudoh agar and the conventional sputum smear method was used. Of the 584 patients included 296 (51%) were women (93 ± 3 years). In 408 (69.7%) sputum and 177 (30.3%) extra pulmonary samples, we diagnosed TB in 16 (2.74%). Of the 11 (1.8%) cases of PTB, only two had positive results in both sputum smear and culture. The 103% of patients with EPTB had no diagnosis or previous treatment. Of the 5 (0.9%) cases with contaminated culture, 3 (0.5%) came from the Emergency Service.

Conclusion: This first Peruvian study on TB in the elderly population showed a low frequency, with more cases reported in men aged between 90 years without prior treatment.

Author(s): Jeel Moya-Salazar, Altea RM Nemolato, Jonathan Samán Vallarta, Israel A Pasco Chavez and Jose Maria Olivo-López

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