Population Aging And Trends Of Pulmonary Tuberculosis Incidence In The Elderly

Objective:To investigate the situation of aging,and to explore the epidemic trend of pulmonary tuberculosis(PTB)in the elderly,and to provide evidence for the prevention and control of PTB.Methods:We collected and collated data of 239,707 newly PTB patients in Shandong Province from 2005 to 2017.We divided the patients into two groups by age,the two groups were elderly(≥60 years old)and non-elderly(<60 years old).We counted the features,incidence and trend of PTB among the elderly group(≥60 years)and the non-elderly group(<60 years)through statistical model and Join-point regression model.Results:The total number of elderly PTB cases were 77192(32.2%).Compared with non-elderly patients,the odds ratio(OR)of men in elderly patients was 1.688(95%CI 1.656-1.722),the OR of rural population in elderly patients was 3.411(95%CI 3.320-3.505)and the OR of smear-positive PTB in elderly patients was 1.213(95%CI 1.193-1.234).The overall reported incidence rate was 35.21(per 100,000).The reported incidence rate of elderly,sputum smear-positive cases were 68.84,35.63(per 100,000),respectively.The reported incidence rate of non-elderly,sputum smear-positive cases in the non-elderly were 68.84,35.63(per 100,000),respectively.The annual reported incidence of PTB in the general population,the elderly and the non-elderly has been slowly decreasing since 2008.The joinpoint regression model showed that the overall reported incidence of PTB in the elderly dramatically declined from 2007 to 2017(APC=-5.3,P<0.05).From 2008 to 2017,the overall incidence of non-elderly PTB decreased year by year(2008-2014,APC=-3.7,P<0.05;2014-2017,APC=-8.0,P<0.05).The reported incidence of sputum smear-positive PTB among elderly patients decreased quickly from 2005 to 2014(2005-2010 APC=-7.2%,P<0.05;2010-2014 APC=-22.6%,P<0.05;2014-2017 APC=-9.0%,P=0.1).The reported incidence of sputum smear-positive PTB among non-elderly patients decreased rapidly from 2005 to 2017(2005-2010 APC=-4.9%,P<0.05;2010-2017 APC=-20.7%,P<0.05).The reported incidence of sputum smear-negative PTB among elderly patients from 2005 to 2017(11.48-38.42/100,000)increased by about 235%.It increased significantly from 2007 to 2014(APC=9.4;P<0.05).The reported incidence of sputum smear-negative PTB among non-elderly patients from 2005 to 2017(5.48-17.52/100,000)increased by about 220%(2005-2008 APC=33.2%,P<0.05;2008-2014 APC=7.8%,P<0.05;2014-2017 APC=-6.6%,P=0.1).Conclusion:The reported incidence of PTB in the elderly population is higher than that in the non-elderly population.The major burden of PTB will shift to the elderly,men,rural population,and smear-negative patients.And with aging,more researches on elderly PTB will promote the achievement of the global TB control goals.