The impact of geriatric tuberculosis patients on the tuberculosis control strategy in China

Objective To study the current status of geriatric tuberculosis (TB) and its impact on TB control program under the directly observed treatment short-course (DOTS) strategy in China. Methods Using the prevalence information regarding the epidemiology of geriatric TB from the National Random Survey in 2000, a case-control study was carried out to analyze the case detection, treatment and management of geriatric TB patients between DOTS area and non-DOTS area. Results The prevalence of sputum smear positive (SS+) in the age group of 65 or above was 440/100 000 which was 3.6 times of the average prevalence of SS+ of all age groups. Geriatric SS+ patients took up 28.8% of all the TB patients in 13 provinces with implementation of DOTS and 28.9% in 15 provinces without. The population of TB casein the age group 65 or above occupied 11.4% of all the newly registered SS+ case in 13 DOTS provinces from 1992 to 2000. Conclusion The prevalence of geriatric SS+ was high. In both DOTS and non-DOTS areas, the proportion of geriatric SS + was high but the registration rate of new SS + was low among all the age groups, Both high prevalence and low case detection rate of geriatric TB became main issues to be under concern in the TB control strategy in China.