Epidemiological features and changing trend of pulmonary tuberculosis in elderly people aged 65 years and above in Renshou County from 2017 to 2022
Objective To analyze the epidemiological characteristics and changing trend of elderly patients with active pulmonary tuberculosis in Renshou County from 2017 to 2022,aiming to provide a basis for the prevention and control of active pulmonary tuberculosis in the elderly.Methods Medical record of elderly patients aged 65 years and over with active tuberculosis diagnosed in the tuberculosis designated hospitals in Renshou County from January 1,2017 to December 31,2022 was collected from the tuberculosis management information system.Demographic characteristics,patient sources,epidemic trends,and treatment classification were analyzed.WPS 2020 was used for data processing and statistical analysis.The difference between groups was compared by using chi-square test,and the significance level was α=0.05.Results From 2017 to 2022,925 cases of elderly pulmonary tuberculosis were registered in Renshou County,including 917 cases(99.14％)transferred from non-designated medical institutions.Totally,46 patients died during treatment,with a male to female ratio of 3.74∶1,and the all-cause mortality was 4.97％.Farmers accounted for 96.22％of total cases.The average annual registration rate of pulmonary tuberculosis in the elderly increased from 32.70/105 in 2017 to 45.78/105 in 2022,sshowing overall upward trend(x2Trend=4.748,P=0.029).The proportion of elderly patients with pulmonary tuberculosis in all registered pulmonary tuberculosis patients increased from 31.08％in 2017 to 45.78％in 2022,showing an increasing trend(x2Trend=28.450,P＜0.001).The retreatment rate of elderly patients with pulmonary tuberculosis increased yearly(x2Trend=11.730,P＜0.001).The all-cause mortality of elderly patients with pulmonary tuberculosis showed an escalating trend(x2Trend=43.054,P＜0.001).The average annual all-cause mortality of elderly patients with pulmonary tuberculosis was 2.13 times of that in the whole population(x2=17.211,P＜0.001).The all-cause mortality of elderly patients with pulmonary tuberculosis increased with age(x2Trend=4.092,P=0.043).The all-cause mortality of retreated elderly patients with pulmonary tuberculosis was 3.61 times higher than that of newly treated patients(x2=11.629,P＜0.001).The mortality of active pulmonary tuberculosis patients with positive etiology was higher than that of patients with negative etiology(x2=4.004,P=0.045).Conclusions From 2017 to 2022,the registration rate of elderly patients with active pulmonary tuberculosis aged 65 and over showed an increasing trend in Renshou County,and the proportion of registered pulmonary tuberculosis patients in the whole population was increasing.The retreatment rate and all-cause mortality also showed an increasing trend.Therefore,it is necessary to strengthen the prevention and control measures of pulmonary tuberculosis in the elderly,especially in the elderly men,farmers and retreated individuals.Scientific and effective treatment programs and active screening measures for pulmonary tuberculosis in the elderly still need to be explored.
active tuberculosiselderlyepidemic characteristicschanging trend
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