Teo Alvin Kuo Jing, Morishita Fukushi, Islam Tauhid, Viney Kerri, Ong Catherine W M, Kato Seiya, Kim HeeJin, Liu Yuhong, Oh Kyung Hyun, Yoshiyama Takashi, Ohkado Akihiro, Rahevar Kalpeshsinh, Kawatsu Lisa, Yanagawa Manami, Prem Kiesha, Yi Siyan, Tran Huong Thi Giang, Marais Ben J
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Lancet Reg Health West Pac. 2023 Apr 20;36:100770. doi: 10.1016/j.lanwpc.2023.100770. eCollection 2023 Jul.
The Western Pacific has one of the fastest-growing older adult populations globally, and tuberculosis (TB) remains one of the foremost infectious causes of disease and death in the region. Older adults are at higher risk of TB due to immunosenescence, comorbidities, and increased institutionalisation. Atypical symptoms and reduced access to health services may delay care-seeking and TB diagnosis, while co-morbidity and increased risk of adverse drug reactions complicate TB treatment. Post-TB sequelae and socioeconomic challenges may decrease the quality of life after TB treatment completion. Despite their high disease burden and special challenges, there is a lack of regionally coordinated policies and guidelines to manage TB among older adults. Routine TB screening at aged-care facilities, age-friendly infrastructure and services, awareness of atypical TB features, integration of TB and non-communicable diseases services, and person-centred approaches to treatment support could improve TB management among older adults. Addressing these challenges and adopting the best practices identified should inform policy formulation and implementation.
This project was funded by 1) the World Health Organization Regional Office for the Western Pacific, with financial contributions from the Government of the Republic of Korea through the Korean Disease Control and Prevention Agency and the Government of Japan through the Ministry of Health, Labour and Welfare, and 2) NUS Start-up Grant. The funders had no role in the paper design, collection, analysis, and interpretation of data and in writing of the paper.
西太平洋地区是全球老年人口增长最快的地区之一，结核病仍然是该地区疾病和死亡的主要传染病病因之一。由于免疫衰老、合并症以及机构化程度增加，老年人患结核病的风险更高。非典型症状以及获得医疗服务的机会减少可能会延迟就医和结核病诊断，而合并症和药物不良反应风险增加则使结核病治疗变得复杂。结核病后遗症和社会经济挑战可能会降低结核病治疗完成后的生活质量。尽管老年结核病患者疾病负担高且面临特殊挑战，但缺乏区域协调的政策和指南来管理老年结核病患者。在老年护理机构进行常规结核病筛查、建立对老年人友好的基础设施和服务、提高对非典型结核病特征的认识、整合结核病和非传染性疾病服务以及采用以患者为中心的治疗支持方法，可以改善老年结核病患者的管理。应对这些挑战并采用已确定的最佳做法应为政策制定和实施提供参考。
本项目由1）世界卫生组织西太平洋区域办事处资助，大韩民国政府通过韩国疾病控制和预防机构以及日本政府通过厚生劳动省提供资金，以及2）新加坡国立大学创业基金资助。资助者在论文设计、数据收集、分析、解释以及论文撰写过程中没有参与。
