Giridharan Prathiksha, Newtonraj Ariarathinam, Thiruvengadam Kannan, Frederick Asha, Selvaraju Sriram
Department of Epidemiology, ICMR - National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India.
Department of Clinical Research, ICMR - National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India.
Indian J Med Res. 2025 Mar;161(3):239-247. doi: 10.25259/IJMR_1625_2024.
Background & objectives Population-based data on tuberculosis (TB) epidemiology are sparsely available from India. A large-scale cross-sectional TB survey was conducted among individuals aged 15 yr and above across Tamil Nadu in India by the State government. Advanced age is one of the major risk factor for TB, so this study undertook a sub-analysis of the data on elderly population from the original TB survey sample. Methods The screening used digital X-ray and sputum testing to diagnose microbiologically confirmed PTB (MCPTB). Results In this study, 1,30,932 participants were screened for TB. Of them, 16,555 (12.64%) were elderly (≥60 yr). Among the elderly, the number of participants diagnosed with MCPTB was 74 (0.45%); MCPTB cases in adults< 60 yr of age were 170 (0.15%). Among the elderly, the crude prevalence of MCPTB per lakh was 447 [95% confidence interval (CI): 351-561], and the adjusted prevalence per lakh was 482 (95% CI: 385-578). Among adults, the crude prevalence of MCPTB per lakh was 130 (95% CI: 111-151), and the adjusted prevalence per lakh was 166 (95% CI: 137-195). Among the elderly population-adjusted prevalence ratio (aPR) of MCPTB was 2.99 (95% CI 2.25-3.98, P<0.0001). Male sex (aPR:2.54; 95% CI: 1.41-4.57), undernutrition (aPR: 3.53; 95% CI: 1.65-7.54), smoking (aPR: 1.94; 95% CI: 1.02-3.71) and past history of TB (aPR: 2.26; 95% CI: 0.92-5.51) were having significantly higher aPR of MCPTB in the elderly population. The number needed to screen (NNS) to diagnose one individual with MCPTB among the elderly group was 224 (95% CI: 178-285), and the total screened population from 15 yr and above was 537 (95% CI: 473-611). Among the elderly participants, NNS was very low among those with a history of TB (56; 95% CI: 26-152), smokers (75; 95% CI: 52-112), and alcohol history (78; 95% CI: 55-114). Interpretation & conclusions Among the elderly individuals, the prevalence of MCPTB was threefold higher, and males, undernutrition, and smoking in the elderly were more likely to have TB.
印度关于结核病（TB）流行病学的基于人群的数据非常稀少。印度泰米尔纳德邦政府对该邦15岁及以上人群开展了一项大规模的横断面结核病调查。高龄是结核病的主要危险因素之一，因此本研究对原始结核病调查样本中的老年人群数据进行了亚分析。方法：筛查采用数字化X线和痰检以诊断微生物学确诊的肺结核（MCPTB）。结果：本研究共筛查了130932名参与者。其中，16555名（12.64%）为老年人（≥60岁）。在老年人中，诊断为MCPTB的参与者有74名（0.45%）；60岁以下成年人中的MCPTB病例有170名（0.15%）。在老年人中，每10万人中MCPTB的粗患病率为447[95%置信区间（CI）：351 - 561]，调整后患病率为482（95%CI：385 - 578）。在成年人中，每10万人中MCPTB的粗患病率为130（95%CI：111 - 151），调整后患病率为166（95%CI：137 - 195）。在老年人群中，MCPTB的人群调整患病率比（aPR）为2.99（95%CI 2.25 - 3.98，P<0.0001）。男性（aPR：2.54；95%CI：1.41 - 4.57）、营养不良（aPR：3.53；95%CI：1.65 - 7.54）、吸烟（aPR：1.94；95%CI：1.02 - 3.71）和既往结核病史（aPR：2.26；95%CI：0.92 - 5.51）在老年人群中MCPTB的aPR显著更高。在老年组中诊断出1例MCPTB个体所需的筛查人数（NNS）为224（95%CI：178 - 285），15岁及以上的总筛查人数为537（95%CI：473 - 611）。在老年参与者中，有结核病史者（56；95%CI：26 - 152）、吸烟者（75；95%CI：52 - 112）和有饮酒史者（78；95%CI：55 - 114）的NNS非常低。解读与结论：在老年个体中，MCPTB的患病率高出三倍，老年男性、营养不良者和吸烟者更易患结核病。
