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Rising case fatality of bacteriologically proven pulmonary tuberculosis in The Netherlands
1Department of Public Health, Erasmus University Medical School, Rotterdam, The Netherlands.
Tubercle and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|April 1, 1992
Summary
Tuberculosis case fatality increased four-fold in Dutch patients from 1973-1984, particularly in the elderly. This rise is likely due to age-related immune decline, impacting treatment effectiveness.
Area of Science:
- Public Health
- Infectious Diseases
- Gerontology
Background:
- Pulmonary tuberculosis remains a significant global health concern.
- The Tuberculosis Control Program (TCP) in the Netherlands monitors tuberculosis cases.
- Trends in tuberculosis case fatality, especially among vulnerable populations, require ongoing investigation.
Purpose of the Study:
- To analyze trends in pulmonary tuberculosis case fatality in Dutch patients between 1973 and 1984.
- To identify demographic factors associated with increased case fatality.
- To explore potential reasons for observed changes in tuberculosis mortality.
Main Methods:
- Retrospective analysis of 125 deceased patients registered by the Tuberculosis Control Program (TCP).
- Data extraction from registration cards focusing on primary cause of death and patient demographics.
- Comparison of case fatality rates between different age groups.
Main Results:
- A four-fold increase in case fatality for bacteriologically proven pulmonary tuberculosis was observed.
- Increased case fatality was predominantly noted in elderly patients.
- Elderly patients presented with non-specific symptoms but had shorter diagnostic delays; bacterial resistance was low (2%).
Conclusions:
- Age-related decline in immune response is a probable key factor in the increased tuberculosis case fatality among the elderly.
- Effective tuberculosis treatment relies on a competent immune system, which is compromised in older individuals.
- Population aging may contribute to increased incidence and mortality of pulmonary tuberculosis in this demographic.