Is Older Age A Risk Factor For Death In New Smear Positive Tuberculosis Patients?

Submitted by,

Gayathri G, Jesna Hassan& Divyasree HK

Guided by,

Dr.Leela Itty Amma.K.R

Head of the Department Community Medicine, Medical Colleg, Thiruvananthapuram

BACKGROUND- Tuberculosis continues to be one of the major public health problems of India. According to the RNTCP performance report for 2006, Kerala had a death rate of 4.9% among New Smear positive (NSP) patients. This is higher than the national average (4.6%). This is a matter of concern since Kerala is a state with high standards of health care. This project aims to find out whether age is a risk factor for death in NSP patients.

OBJECTIVES-

1. To determine whether there is any significant relationship between age and death among NSP patients registered in Trivandrum, in 2006, who had treatment outcome as death or cured.
2. To determine the distribution of age, sex and sputum positivity among NSP patients registered in Trivandrum, in 2006, who had treatment outcome as death or cured.

METHODOLOGY-

This was a record based study. Information was collected from the registers of the 6 TB units of Trivandrum for 2006. Distribution of age, sex and sputum positivity among NSP patients registered in the District Tuberculosis Centre, Trivandrum, in 2006, who had treatment outcome as death and of those who had a treatment outcome as cured, was determined. A case control study was conducted to determine whether there is any significant relationship between age and death. The cases were all the deaths among NSP patients registered in 2006 and controls were systematically selected from all the NSP patients registered in 2006 who were cured. Analysis was done using proportions, chi-square test and odds ratio.

RESULTS-

Among the patients who died, 11.5% were females and 88.5% were males while among those who were cured, 22.6% were females and 77.4% were males. 53.8% of the patients who died had sputum positivity of 3+, while this was 50% for those who were cured. Mean age of the patients who died was 61.15 and that of those who were cured was 47.82. Age>50 years was a significant risk factor for death (odds ratio= 3.433). Age>65 years was a significant risk factor for death                            (odds ratio= 6.92).

CONCLUSION-

Age is a significant risk factor for death with 75% of the deaths occurring in patients above 50 years. This highlights the need for a more cautious approach while treating such patients. No significant difference could be demonstrated in distribution of sex/sputum positivity among those who died and those who got cured.