Touré N O, Dia Kane Y, Diatta A, Ba Diop S, Niang A, Ndiaye E M, Thiam K, Mbaye F B R, Badiane M, Hane A A
Service de pneumologie, CHN de Fann, Dakar, Sénégal.
Rev Mal Respir. 2010 Nov;27(9):1062-8. doi: 10.1016/j.rmr.2010.04.017. Epub 2010 Oct 27.
The purpose of this study was to compare the epidemiology, clinical features and clinical course of primary presentations with pulmonary tuberculosis occurring in older and younger patients.
We undertook a prospective, comparative study in the Pneumology clinic of the National University Hospital of Fann in Dakar, from April 1, 2005 to March 31, 2006, collecting data on all patients presenting with a first episode of bacterially confirmed pulmonary tuberculosis.
We studied 187 first presentations with confirmed pulmonary tuberculosis including 12.8% (n=24) elderly (>55 years) subjects (20 men and four women) and 87.2% (n=163) younger subjects (105 men and 58 women). In the older subjects, patients were more commonly men (sex-ratio: 5), without formal education, and working in the primary or informal sector. Comorbidities were more frequent in the older group, including smoking (P=0.002), alcohol consumption (P=0.01), diabetes (37.5%) (P<0.005) and obesity with BMI superior than 20 in 25%. Pulmonary shadowing was common (41.7% of the cases), P=0.008 and generally bilateral P=0.0001 with cavitation, but this observation was not statistically significant.
Complications were more frequent in the older patient (20.8%), as was mortality (29.3%, P=0.000) and rate of clinical improvement in response to treatment was less satisfactory (50%) there.
