JMIR Publications

ABSTRACT

Background:

With a progressive increase in the aging process, the challenge from pulmonary tuberculosis (PTB) for the elderly population also increasing.

Objective:

This study aimed to identify the epidemiological distribution of PTB among the elderly group, assess the performance of the World Health Organization’s 2025 goal in this specific group, and predict the further advancement of PTB in the eastern area of China.

Methods:

All notified active PTB cases with the age >65 years in Zhejiang Province were screened and analyzed. The general epidemiology characteristics were depicted and presented using the ArcGIS software. Further prediction of PTB was performed using R software.

Results:

Altogether, 41,431 cases with an age group >65 years were notified in the surveillance system from 2015 to 2020. After excluding extrapulmonary TB, we determined 39,832 PTB cases consisting of the bacteriological diagnosis (59.41%) and clinical diagnosis (40.59%). The notified incidence indicated an evident downward trend with a reduction of 30%, while the bacteriologically-positive incidence were steady at approximately 60/100,000. From the geographical distribution, Quzhou and Jinhua cities had a higher PTB incidence among the elderly. The delay of PTB diagnosis was identified, and a significantly prolonged treatment course was observed in the elderly. Moreover, a 50% reduction of PTB incidence by the middle of 2024 was predicted using a linear regression model. The Holt-Winters exponential smoothing model would be a better model to fit the available PTB number in the elderly than a seasonal ARIMA model.

Conclusions:

More comprehensive and effective interventions should be implemented in the elderly based on the findings from the available surveillance. A more systematic assessment of the PTB epidemic trend in this specific group should be considered to incorporate more influencing factors.