Tuberculosis in the elderly in Hong Kong

Area of Science:

• Public Health
• Epidemiology
• Gerontology

Background:

• Tuberculosis (TB) rates in Hong Kong have declined since the 1950s but remain persistently high (approx. 110/100,000).
• The underlying reasons for this sustained high TB incidence have not been clearly understood.

Purpose of the Study:

• To analyze the trend of tuberculosis notification rates in Hong Kong from 1989 to 1998.
• To investigate the clinical characteristics of tuberculosis patients aged 60 years and older.
• To compare the clinical profiles and outcomes of older TB patients with younger age groups.

Main Methods:

• Utilized tuberculosis notification data from the Hong Kong Government Tuberculosis and Chest Service (1989-1998).
• Conducted a detailed study of all tuberculosis patients registered for treatment in 1996.
• Compared epidemiological and clinical data across different age demographics.

Main Results:

• Tuberculosis notification rates decreased in individuals under 60, remained stable in the 60-69 age group, and increased in those aged 70 and above.
• A significant rise in bacteriologically confirmed tuberculosis cases was observed in older age groups.
• The proportion of tuberculosis cases over 60 years old increased from 31.9% in 1989 to 45.4% in 1998, largely accounting for the total increase in cases.
• Older patients exhibited more advanced disease at diagnosis, higher comorbidity rates, and significantly increased mortality compared to younger patients.

Conclusions:

• Increasing life expectancy and a high tuberculosis burden in the elderly population are key contributors to the persistent high rates of tuberculosis in Hong Kong.
• The aging demographic significantly impacts tuberculosis epidemiology and necessitates targeted public health strategies for the elderly.