Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 years and Older

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With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential. Method Clinical, radiological features, treatment and outcome of TB in patients aged 75 years or older was evaluated retrospectively. Results Among 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p=0.007). Conclusion Tuberculosis is associated with high mortality in patients above age of 75. There is still a substantial delay in TB diagnosis in elderly. RIPE regimen is frequently changed due to side effect. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient’s population is needed to define the best effective therapeutic approach. Tuberculosis Elderly TB in Saudi mortality Disseminated Tuberculosis Figures Figure 1 Introduction Tuberculosis (TB) is a major public health concern despite the delegation efforts made by the World Health Organization (WHO) and partners to improve its control[ 1 ]. It is the 13th leading cause of death worldwide[ 2 ]. Multiple observational studies conducted in the Western Pacific, Eastern Mediterranean, and Southeast Asian regions, TB cases are rising among the elderly, particularly those who are 65 years and older [ 3 – 6 ]. Similar trends have been observed in European regions. For instance, in France in 2019, the reported percentage of TB cases was 17.5% among individuals aged over 65, 9.8% among those over 75, and 6.3% among those over 80[ 7 ]. Several investigators have indicated a direct link between age and the risk of mortality in patients with TB [ 2 , 8 , 9 ]. In a large TB treatment trial in the United States and Canada, mortality was highest with increased age [ 8 ]. Similarly, a study involving Taiwanese TB patients highlighted an elevated risk of mortality in the age group of ≥ 75 years [ 10 ]. In a Saudi Arabia, Aljadani et al reported an overall mortality rate of 22 per 1000/yeas among Saudi TB cases, with the highest mortality rates among the elderly, males, and patients with pulmonary TB [ 11 ].As the life expectancy is increasing worldwide, TB in older people will become a significant diagnostic and therapeutic challenges[ 12 ]. This study aims to describe the clinical characteristics of TB in patients above age of 75, identify the different anti-TB regimen received, and treatment outcomes. Methods We identified all cases of TB admitted or treated as an outpatient at King Abdulaziz Medical City, Riyadh, Saudi Arabia during the period from January 2015 to December 2021. A chart review was conducted including patients aged 75 years or older, diagnosed with Pulmonary Tuberculosis (PTB), Extra-Pulmonary Tuberculosis (EPT) or Disseminated Tuberculosis (DTB) based on a positive AFB culture, positive TB PCR from sputum, tissues or fluid or compatible histopathological changes, compatible clinical presentation with documented radiological response after starting on anti TB medications. Only patients who were initiated on anti-tuberculous medications were included. Collected data included patients, age, gender, comorbidities history of TB or contact with active TB patients, use of immune suppressive medications, presenting complains and time interval from the onset of symptoms until confirmation of TB diagnosis (less than 30 days, between 31–90 days, and more than 90 days) We also collected data on initial laboratory investigations, including complete blood count (CBC), inflammatory markers (ESR, CRP), liver function tests (LFT) and renal function tests. Radiological findings of chest x ray and CT chest were obtained from radiological reports. Data pertaining to initial TB treatment was collected. Typical initial regimen is defined as initiating therapy with 4 drugs namely Isoniazid, Rifampicin, Pyrazinamide and Ethambutol (RIPE regimen). Atypical initial therapy regimen is defined as any modification of the previously mentioned drugs either by substitution or omission of one or more drugs. Any modification of the initial regimens was documented including the indication for the modification, nature of modification (omission, addition, or substitution of drugs). Outcome of TB therapy was documented. The study received ethical approval from the Ethics Committee at King Abdullah International Medical Research Center (KAIMRC) under approval number IRB/2609/22 . Statistical analysis A comprehensive statistical analysis was conducted on the dataset, encompassing both descriptive and inferential methodologies. Firstly, a descriptive analysis is conducted to summarize the demographic characteristics of the participants, which include age, gender, and other features. This provides an overview of the study population. Subsequently, inferential analyses such as Fisher’s Exact Test or ANOVA (for more than two groups) are employed to examine the significant difference between variables. Binary Logistic Regression is used to find out the predictors of delayed diagnosis and mortality as outcome. Statistical significance is established at a p-value of 0.05 or lower and a 95% Confidence Interval. All statistical analyses are executed using IBM's SPSS Software, version 29.0.0. Results Demographic and presenting symptoms: We identified 92 patients with TB, most were male, 40 patients (76.1%). The mean age was 82.5 ± 6.8 years. Forty-eight patients were diagnosed as PTB (52.2%), 30 patients as EPTB (32.6%) and 14 patients (15.2%) were diagnosed as DTB. Spinal tuberculosis was the most common extrapulmonary form of Tuberculosis occurring in 12 patients followed by TB lymphadenitis in 7 patients. (Table 1 ) The most common presenting symptoms were cough in 47 patients (51.1%), fever in 40 patients (43.5%), dyspnea in 36 patients (39.1%), weight loss in 29 patients (31.5%), night sweats in 15 patients (16.3%), and hemoptysis in 9 patients (9.8%). Additionally, 55 patients (59.8%) exhibited other symptoms like poor oral intake and low back pain. (Table 1 ) The time interval from symptom onset to diagnosis varied. In 33 patients (35.9%), diagnosis of TB was established ≤ 30 days from start of symptoms, 30 patients (32.6%) diagnosis was confirmed 31–90 days from symptoms, and in 29 patients (31.5%) diagnosis was established after 3 months of symptoms. (Table 1 ) The most prevalent comorbidity was Diabetes Mellitus (DM) in 55 patients (59.8%) and Congestive Heart Failure (CHF) in 38 patients (41.3%). Other comorbidities include chronic kidney disease (CKD) in 23 patients (25%), Hemodialysis in 10 patients (10.9%), Chronic Liver Disease (CLD) in 6 patients (6.5%) and chronic respiratory disease (Asthma and COPD) in 4 patients (4.3%). Seven patients were immunocompromised or on Immunosuppressive Therapy (7.6%). History of prior TB was present in 8 patients (8.7%). History of recent contact with TB was documented on 4 patients (4.3%). (Table 1 ) Logistic regression analysis identifying adjusted predictors of delay in the diagnosis of tuberculosis (TB). Weight loss has a significant positive association with delay (B = 1.991, p = 0.003), with an odds ratio (Exp (B)) of 7.322, indicating that elderly individuals experiencing weight loss are approximately 7 times more likely to face delayed TB diagnosis. Furthermore, gender (male) also demonstrates significance (B=-1.379, p = 0.030), with an odds ratio of 0.252, suggesting that males have a lower likelihood of delayed diagnosis compared to females. Other symptoms and age did not show significant associations. (Table 2 ) Initial Labs, and Radiological findings Different Laboratory findings according to different types of TB shown in Table 2 . Patients with DTB had significantly more eosinophilia (defined as eosinophil count more than ≥ 500cells/mcL) compared to those with PTB or EPTB ( p = 0.026 ). Thrombocytopenia (defined as Platelet count of < 150 cells/mcL) was also significantly more prevalent in patients with DTB ( p = 0.003 ). The mean C-reactive protein and Albumin levels were significantly lower in patients with PTB compared to patient with DTB or EPTB. (Table 3 ) The most prevalent radiological findings in Tuberculosis in this group is shown in figure (1). Consolidation was present in 47 patients (51.1%), Upper Lung lobe involvement occurred in 46 patients (50%) while lower lobe involvement was present in 31 patients (33.7%). Middle lobe involvement was present in 17 patients (18.5%). Pleural Effusion was present in 46 patients (50%). Lymph node enlargement was present in 39 patients (42.4%). Other common findings include ground glass opacity in 20 patients (21.7%), and cavitation in 19 patients (20.7%) (Fig. 1 ). Diagnosis, and Treatment The diagnosis of TB was confirmed by a positive culture in 50 patients (54%), by PCR alone in 2 patients (2.2%), while diagnosis was based on a histological finding compatible with TB (granuloma) in 36 patients (39%). Clinical diagnosis of TB without confirmatory tests was made in 4 patients (4.3), all of whom were started on Anti-TB therapy and showed clinical and radiological response (Table 1 ) Typical initial RIPE regimen was used in 82 patients (89.1%) while an initial modified regimen was used in 17 patients (28.3%). Treatment adjustment within the first 2 months occurred in 24 patients (26.1%). The most frequent reason to modify an initial typical 4 drug regimen was increase in liver enzymes (ALT) occurring in 18 patients (20.7%). Other adverse reactions include skin rashes and gastro-toxicity reported in 3, and 3 patients respectively (3.3%). Thrombocytopenia is the least frequently reported adverse effect, affecting one patient (1.1%) of patients. (Table 4 ) PZA was the most common cause of altered liver enzymes, in 10 of the 18 patients (55.5%), followed by INH and Rifampicin, in 2 patients each. In the other 4 patients, both INH and PZA were stopped concomitantly and were never restarted again. Other causes of modifications were poor compliance in two patients and anaphylaxis reaction in one patient (PZA was blamed). In two additional patients, same initial drugs were continued but more drugs were added because of worsening symptoms. Side effects Pyrazinamide was the most frequently discontinued drug from initial regimen in 14 patients (15%) and Moxifloxacin was the most frequently introduced medication in 15 patients (16.3%) patients followed by Amikacin in 4 patients and Linezolid in one patient. INH and Rifampicin were replaced in 6 (6.5%) and 8 patients (8.7%) respectively. (Table 4 ) Initial modified regimen was used in 17 patients. Two of the initial RIPE drugs were substituted in one patient and 3 drugs were all substituted in another 3 patients (3%). In two patients, the whole 4 drugs were stopped together for transaminases and then re-started again with no increase in liver enzymes with the re-challenge. In three patients, only omission of one drug was done and three drugs only were used in treatment for the initial two months of therapy. The most frequent initial atypical TB treatment regimen was a 4-drug regimen with Ethambutol, Moxifloxacin, Rifampicin and Isoniazid in 3 patients, and a 3-drug regimen with Ethambutol, INH and wither Moxifloxacin or Rifampicin in 4 patients. Moxifloxacin was the most frequently used drug from the second line agents. Modification due to resistant strain only occurred in one patient (1.1%) Outcome Successful completion of intended TB therapy (cure) was achieved in 53 patients (67.6%). Twenty-two patients died during TB therapy (23.9) while follow up was lost during therapy in 17 patients (18.5%). Causes of death was respiratory failure in 8 patients (8.7%), septic shock with multi-organ failure in 7 patients (7.6%). No documented reason of death in 7 patient (7.6%). (Table 4 ) Predictors of mortality in TB among elderly patients include the significant negative association of fever (B=-2.532, p = 0.032) and lower lobe involvement (B=-2.199, p = 0.036). Conversely, night sweats (B = 1.288, p = 0.428 ), hemoptysis (B = 1.750, p = 0.084) and Ground glass opacity (B=-2.521, p = 0.045) demonstrate positive associations with higher mortality (Table 5 ). Patients with pulmonary tuberculosis has higher mortality compared to those with extrapulmonary tuberculosis both during TB therapy and after completion of treatment (p = 0.007 and p = 0.019). Discussion Despite a decreasing incidence of newly diagnosed TB cases in many parts of the world including Saudi Arabia, incidence of tuberculosis in older persons (aged ≥ 65 years) still constitute a significant proportion of all notified TB cases [ 13 , 14 ]. In Japan and Korea, 69% and 51 of newly diagnosed TB cases were in patient aged 65 and older [ 15 ]. In Western Pacific Region, Tuberculosis in the elderly was 19.5%, the highest of the total TB incidence in that region [ 15 ]. Tuberculosis also remains a leading cause of death worldwide, with older age recognized as a major risk factor for TB-related death [ 16 ]. We aimed in this study to evaluate the profile and outcomes of TB in the elderly in Saudi Arabia, which is still considered a country with a moderate burden of Tuberculosis. Tuberculosis in elderly is usually secondary to reactivation especially in countries with lower TB burden [ 17 – 19 ]. Progression of a primary TB infection or reactivation of TB may also occur in elderly due to age-associated immune dysfunction and associated comorbidities especially in countries with high TB burden and transmission [ 20 – 24 ]. In our study the majority of our patients had underlying comorbidities and we believe the reactivation is the most likely mechanism of TB disease in this group. Only 4 of our patients (4.3%) gave a history of recent exposure to confirmed TB cases. Fifty-five of our patients (59.8%) presented with less specific symptoms such as fatigue, back pain, and low oral intake. The typical clinical presentation of tuberculosis like prolonged cough, hemoptysis and weight loss may be less prominent in elderly persons. The presenting symptoms and signs may also be confounded by concurrent comorbidities including structural lung disease like COPD, making TB more challenging to diagnose in older adults and leading to delay in diagnosis or even misdiagnosis with malignancies for example. Patients may also dismiss some of the symptoms like cough attributing it to other illness common in older people like COPD [ 6 , 25 – 30 ]. More than two thirds of patients ultimately diagnosed with Tuberculosis were not recognized on initial hospitalization; the majority (64%) of those with initial missed diagnosis were aged > 60 years [ 31 – 33 ]. There was a delay of 3 months or more before the diagnosis was established in more than one third of our patients. In a study done in China, the median time from symptom onset to TB disease diagnosis was > 90 days among older adults [ 31 ]. Delay in diagnosis will result in more advanced disease at time of diagnosis, more likelihood of transmission and potentially higher mortality. This delay in diagnosis may be a factor contributing to high mortality observed in our study. Some of the symptoms like weight loss may miss guide the physicians to malignancy. In our study, weight loss was significantly associated with delayed diagnosis. Inadequate TB awareness and knowledge about TB in elderly has been reported in some countries [ 34 , 35 ]. Interventions designed to explore the awareness and knowledge about TB disease and its symptoms in older Saudi citizens is warranted. Radiological features of TB in older people may be different than in younger population. Various studies reported less prevalence of typical lung cavitation, consolidation or pulmonary nodules [ 16 , 36 – 39 ] In our study however, both cavity lung disease, upper lobe involvement and pleural effusion occurs in half of the patientsLower lobe involvement and nodular changes were less commonly present compared to other reports [ 9 , 40 , 41 ]. Selecting a regimen for treatment of TB in older people may also be challenging for many reasons. Polypharmacy and drug to drug interactions with TB medications is common in elderly due to multiple coexisting illness [ 54 – 56 ]. The two main first line medication, INH and in particular Rifampicin is associated with drug-to-drug interaction like with the anticoagulants DOAC and warfarin. Older people with TB above age of 85 years have a higher risk of treatment failure and a higher rate of treatment interruption due to side effects [57, 58]. There was no documentation of treatment failure in our group, however modifications of initial regimens were due to worsening symptoms in two patients only. Adverse effects of TB medication in elder are also a significant concern. All the three first line drug therapy for TB. INH, rifampicin and pyrazinamide are associated with hepatoxicity in elderly [ 42 – 44 ]. In elderly people, pyrazinamide omission from the initial regimen is suggested by some authors to avoid toxicity [ 45 ]. American guideline does not recommend the use of pyrazinamide during the intensive phase in elderly above 75 years with moderate disease and lower resistance risk [ 9 ]. Other studies, however, did not find an association between PZA containing regimens use and higher treatment discontinuation rates, liver toxicity, or death in older people [ 45 – 47 ]. WHO has not recommended any specific TB treatment regimen in the elderly. PZA is not the only anti TB medication that pose a problem in eldest [ 48 ]. Although Elderlies are more likely to have vision related medical problems which increase potential toxicity of Ethambutol[ 49 ]. Ethambutol side effects were not reported frequently in our patients, significant side effects from this medication were common in elderly people in some other studies. There was no documentation of routine visual acuity assessment in patients taking this medication in our study. Two of the most commonly used (so called second line therapy) anti-TB agents are Moxifloxacin and Linezolid. Moxifloxacin is being increasingly incorporated as part of initial regimen. The drug has a high risk of hepatic toxicity, QT prolongation and tendinitis in older people[ 50 , 51 ]. Safety of linezolid use in elderly in older people is not well known [ 52 , 53 ]. Linezolid has been used in few of our patients. Drug resistance in our population was very low. This was similarly shown in other parts of the world. In Germany, resistance rate of all anti TB medication was lower in older persons (6.5 vs. 13.9%) including those with multi resistant isolates (MDR) (0.6 vs. 3.1%) [59]. in another cohort of more than 3000 patients from China, primary TB cases in elderly had a lower rate of drug resistant TB, multi drug resistant TB, Rifampin resistance TB and streptomycin resistant TB. Resistance to INH and Ethambutol however was higher among elderly [ 54 ]. Limitation This is a single center study and results may be limited to this geographical location. The large number of patients lost to follow could have affected the mortality rate. Many of the lost follow ups are likely dead. This conclusion is made because all of the patients in this group are Saudi citizens who have full eligibility in this tertiary center and are very unlikely to seek heath care elsewhere at their age. Loss of follow up is not uncommon in elderly with TB [ 53 ]. We also did not assess adherence to medications which was found to be a problem in some other studies [ 55 – 57 ]. Conclusion The diagnosis and treatment of tuberculosis (TB) in elderly patients (over 75 years) presents a significant challenge. Nonspecific symptoms, delays in diagnosis, and frequent adverse reactions to medications all contribute to this complexity. A critical reevaluation of current diagnostic and therapeutic approaches is warranted. Existing literature suggests concerning trends: frequent modifications to initial drug regimens, often lacking robust evidence and potentially reflecting physician bias. While establishing a association between TB infection and mortality in elderly can be difficult, further targeted research is essential to define the most efficacious treatment strategies for this group of patients. Declarations Ethics approval and consent to participate The Institutional Review Board at King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia ( IRB/2609/22 ), approved the study. Patient confidentiality was ensured, and the collected patients' data used by the research team only Consent for publication : All authors agree for publication Availability of data and materials : available Competing interests : none Funding : None Acknowledgements : none Author Contribution SB: Supervision of the research Conception and design of Study, participate in writing the draft and final manuscriptAA :Collecting , Acquisition of data HR: Collecting , Acquisition of data HJ : Conception the study , participate in writing the final manuscriptLL : Analysis and interpretation of dataES: Literature review , review and reference updateAll authors have critically reviewed the manuscript for important intellectual contents, approved the final draft and are responsible for the content and similarity index of the manuscript References W. H. O. (WHO). "Global Tuberculosis Report 2013." http://www.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf?ua=1 . (accessed. W. H. O. 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Ananthakrishnan et al. , "The profile and treatment outcomes of the older (aged 60 years and above) tuberculosis patients in Tamilnadu, South India," PloS one, vol. 8, no. 7, p. e67288, 2013. H. S. Schaaf, A. Collins, A. Bekker, and P. D. Davies, "Tuberculosis at extremes of age," (in eng), Respirology, vol. 15, no. 5, pp. 747-63, Jul 2010, doi: 10.1111/j.1440-1843.2010.01784.x. B. S. Kwon et al. , "The high incidence of severe adverse events due to pyrazinamide in elderly patients with tuberculosis," PloS one, vol. 15, no. 7, p. e0236109, 2020. M. Wada, "[Effectiveness and problems of PZA-containing 6-month regimen for the treatment of new pulmonary tuberculosis patients]," (in jpn), Kekkaku, vol. 76, no. 1, pp. 33-43, Jan 2001. Y. T. Wang et al. , "Ministry of Health Clinical Practice Guidelines: Prevention, Diagnosis and Management of Tuberculosis," (in eng), Singapore Med J, vol. 57, no. 3, pp. 118-24; quiz 125, Mar 2016, doi: 10.11622/smedj.2016051. E. Hagiwara et al. , "Safety of pyrazinamide-including regimen in late elderly patients with pulmonary tuberculosis: A prospective randomized open-label study," (in eng), J Infect Chemother, vol. 25, no. 12, pp. 1026-1030, Dec 2019, doi: 10.1016/j.jiac.2019.05.030. T. Takaku, T. Saito, K. Nemoto, S. Oisihi, and K. Hayashihara, "Comparison of adverse effects in tuberculosis patients over 80 years of age with and without pyrazinamide treatment," ed: Eur Respiratory Soc, 2017. I. Hase et al. , "Pulmonary Tuberculosis in Older Adults: Increased Mortality Related to Tuberculosis Within Two Months of Treatment Initiation," (in eng), Drugs Aging, vol. 38, no. 9, pp. 807-815, Sep 2021, doi: 10.1007/s40266-021-00880-4. J. I. Jeong et al. , "The influence of adverse drug reactions on first-line anti-tuberculosis chemotherapy in the elderly patients," Tuberculosis and Respiratory Diseases, vol. 67, no. 4, pp. 325-330, 2009. R. Stahlmann and H. M. Lode, "Risks associated with the therapeutic use of fluoroquinolones," (in eng), Expert Opin Drug Saf, vol. 12, no. 4, pp. 497-505, Jul 2013, doi: 10.1517/14740338.2013.796362. W. H. Organization. "WHO consolidated guidelines on drug-resistant tuberculosis treatment." https://www.ncbi.nlm.nih.gov/books/NBK539517/ (accessed. Z. Lan et al. , "Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis," (in eng), Lancet Respir Med, vol. 8, no. 4, pp. 383-394, Apr 2020, doi: 10.1016/s2213-2600(20)30047-3. B. Singh, D. Cocker, H. Ryan, and D. J. Sloan, "Linezolid for drug-resistant pulmonary tuberculosis," (in eng), Cochrane Database Syst Rev, vol. 3, no. 3, p. Cd012836, Mar 20 2019, doi: 10.1002/14651858.CD012836.pub2. Q. An et al. , "Primary drug-resistance pattern and trend in elderly tuberculosis patients in Shandong, China, from 2004 to 2019," Infection and Drug Resistance, pp. 4133-4145, 2020. L. Mallet, A. Spinewine, and A. Huang, "The challenge of managing drug interactions in elderly people," (in eng), Lancet, vol. 370, no. 9582, pp. 185-191, Jul 14 2007, doi: 10.1016/s0140-6736(07)61092-7. C. C. Leung et al. , "Tuberculosis in older people: a retrospective and comparative study from Hong Kong," (in eng), J Am Geriatr Soc, vol. 50, no. 7, pp. 1219-26, Jul 2002, doi: 10.1046/j.1532-5415.2002.50308.x. S. Bele et al. , "Population aging and migrant workers: bottlenecks in tuberculosis control in rural China," PLoS One, vol. 9, no. 2, p. e88290, 2014. Tables Table 1 : Sociodemographic parameters, prevalence of different TB types and presenting symptoms ^ TB peritonitis, Testicular TB and chest wall TB * Decrease level of consciousness, confusion ** Fatigue, malaise, decrease oral intake. *** Induced sputum, bronchoscopic lavage Table 2: - Adjusted predictors of delay in diagnosis of TB (Logistic Regression Analysis ) B Sig. Exp(B) 95% CI Lower Upper Age .000 1.000 1.000 .933 1.072 Gender (Male) -1.379 .030 .252 .073 .872 Dyspnea .301 .644 1.352 .377 4.847 Cough -.153 .817 .858 .235 3.133 Fever -.044 .933 .957 .341 2.685 Night Sweat .094 .912 1.099 .206 5.859 Hemoptysis -.201 .818 .818 .148 4.527 Weight Loss 1.991 .003 7.322 1.924 27.858 Others .806 .142 2.238 .764 6.559 Constant .619 .836 1.856 Table 3: Different laboratory finding according to different type of TB (ANOVA) Pulmonary TB Extra-Pulmonary TB Disseminated TB‎ Overall Sig. Value Mean (SD) Mean (SD) Mean (SD) Mean (SD) White Blood Cell Count 10.96 (16.4) 8.17 (4.3) 5.30 (2.6) 9.15 (12.1) 0.275 Lymphocyte 17.34 (9.6) 22.70 (9.9) 18.71 (18.2) 19.12 (11.4) 0.257 Polymorph Neutrophils 65.21 (19.1) 60.73 (15.0) 55.69 (28.8) 62.46 (19.8) 0.377 Eosinophils 1.63 (4.9) .80 (1.5) 13.93 (33.1) 3.28 (13.7) 0.026 Hemoglobin 115.52 (20.3) 118.13 (18.2) 103.57 (17.5) 114.53 (19.6) 0.063 Hematocrit 0.36 (0.06) 0.35 (0.06) 0.32 (0.05) 0.35 (0.06) 0.082 Platelets 299.78 (135.4) 315.55 (117.7) 176.57 (111.2) 285.54 (133.8) 0.003 Erythrocyte Sedimentation Rate 83.92 (29.2) 81.19 (28.3) 71.11 (42.7) 80.87 (30.8) 0.569 C reactive protein 95.22 (71.1) 48.86 (32.5) 109.53 (72.6) 80.09 (63.7) 0.009 Procalcitonin 0.17 (0.10) 2.52 (6.5) 0.38 (0.33) 1.39 (4.6) 0.574 Alkaline Phosphatase 154.89 (106.97) 162.03 (108.9) 161.29 (146.9) 158.22 (113.2) 0.960 Gamma-glutamyl transpeptidase 190.45 (157.1) 214.28 (229.4) 178.50 (123.2) 198.82 (183.9) 0.902 Aspartate Aminotransferase 33.57 (23.7) 35.86 (26.7) 38.79 (17.3) 35.13 (23.7) 0.760 Alanine Aminotransferase 24.85 (18.6) 30.66 (34.2) 24.93 (11.6) 26.75 (24.0) 0.574 Albumin 28.76 (7.9) 32.04 (5.8) 26.14 (4.6) 29.41 (7.1) 0.026 Total Bilirubin 12.68 (9.0) 11.32 (8.2) 14.46 (11.6) 12.51 (9.1) 0.573 Blood Urea Nitrogen 7.78 (5.3) 7.76 (5.1) 9.30 (4.9) 8.01 (5.2) 0.606 Uric Acid 294.35 (152.7) 308.64 (125.9) 311.33 (207.8) 301.63 (151.7) 0.903 Creatinine 126.56 (172.5) 139.47 (170.4) 142.07 (133.6) 133.35 (164.7) 0.926 Table 4: Treatment related Features of TB Patients Frequency (n= 92 ) Percent Treatment Duration Patients who completed therapy Patients died during therapy Months (Mean, SD) 7.1 (5.2) Days (Mean, SD) 12.1 (7.2) Initial Regimen Typical Regimen (Ethambutol/Pyrazinamide/Rifampin/Isoniazid) 82 89.1 Modified Regimen 10 10.9 Adjustment of Initial Treatment Yes 24 26.1 Changes due to Resistance 1 1.1 Rechallenged Initial Regimen Yes 13 14.1 Final Regimen Typical Regimen (Ethambutol/Pyrazinamide/Rifampin/Isoniazid) 65 70.7 Modified Regimen 27 29.3 Adverse Reaction due to Treatment Yes 18 19.6 Outcome of Treatment Complete therapy 53 57.6 Died during before completion of therapy 22 23.9 Died after completion of therapy 16 17.4 Lost Follow-Up during treatment 17 18.5 Lost follow up after treatment completion 16 17.4 Causes of death during therapy Respiratory Failure 8 8.7 Septic Shock with MOF 7 7.6 Unknown 7 7.6 Causes of death after completion of therapy Cardiovascular even Pneumonia (bacterial, Viral) Malignancy Liver cirrhosis Unknown 4 6 2 2 2 4.3 6.5 2.2 2.2 2.2 Table 5: - Adjusted predictors of poor outcome (Mortality) in TB (Logistic Regression Analysis) B Sig. Exp(B) 95% CI Lower Upper Age .065 .246 1.067 .956 1.192 Gender (Male) .317 .734 1.373 .221 8.523 Presentin g Features Cough .952 .381 2.591 .308 21.790 Fever -2.532 .032 .080 .008 .806 Dyspnea -1.039 .229 .354 .065 1.925 Weight Loss -1.059 .461 .347 .021 5.776 Night Sweats 1.288 .428 3.627 .150 87.636 Hemoptysis 1.750 .084 5.756 .793 41.799 Presence of Other Symptoms -1.451 .127 .234 .036 1.512 Pathological Features Consolidation 1.403 .206 4.069 .462 35.802 Upper Lung Lobe Involvement .791 .440 2.207 .296 16.422 Pleural Effusion 1.128 .225 3.089 .500 19.100 Lymph Node Enlargement -.455 .705 .634 .060 6.713 Lower Lobe Involvement -2.199 .036 .111 .014 .869 Nodules 1.382 .267 3.984 .346 45.808 Ground Glass Opacity -2.521 .045 .080 .007 .948 Cavitation -.720 .463 .487 .071 3.328 Middle Lung Lobe Involvement .233 .835 1.262 .141 11.315 Micronodules 1.732 .131 5.652 .598 53.408 Tree in Bud Appearance .860 .498 2.363 .196 28.456 Mass .674 .670 1.962 .088 43.578 Bronchiectasis -.451 .601 .637 .118 3.451 Pleural Thickening .198 .810 1.219 .243 6.126 Fibrotic Changes -22.801 .998 .000 .000 . Treatment Treatment (Atypical) .351 .634 1.421 .334 6.037 Constant -5.575 .249 .004 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 21 Apr, 2024 Reviews received at journal 21 Apr, 2024 Reviews received at journal 13 Apr, 2024 Reviewers agreed at journal 11 Apr, 2024 Reviewers agreed at journal 10 Apr, 2024 Reviewers agreed at journal 10 Apr, 2024 Reviews received at journal 06 Apr, 2024 Reviewers agreed at journal 04 Apr, 2024 Reviewers invited by journal 04 Apr, 2024 Editor assigned by journal 04 Apr, 2024 Submission checks completed at journal 02 Apr, 2024 First submitted to journal 26 Mar, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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It is the 13th leading cause of death worldwide[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Multiple observational studies conducted in the Western Pacific, Eastern Mediterranean, and Southeast Asian regions, TB cases are rising among the elderly, particularly those who are 65 years and older [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Similar trends have been observed in European regions. For instance, in France in 2019, the reported percentage of TB cases was 17.5% among individuals aged over 65, 9.8% among those over 75, and 6.3% among those over 80[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral investigators have indicated a direct link between age and the risk of mortality in patients with TB [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In a large TB treatment trial in the United States and Canada, mortality was highest with increased age [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Similarly, a study involving Taiwanese TB patients highlighted an elevated risk of mortality in the age group of \u0026ge;\u0026thinsp;75 years [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn a Saudi Arabia, Aljadani et al reported an overall mortality rate of 22 per 1000/yeas among Saudi TB cases, with the highest mortality rates among the elderly, males, and patients with pulmonary TB [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].As the life expectancy is increasing worldwide, TB in older people will become a significant diagnostic and therapeutic challenges[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis study aims to describe the clinical characteristics of TB in patients above age of 75, identify the different anti-TB regimen received, and treatment outcomes.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eWe identified all cases of TB admitted or treated as an outpatient at King Abdulaziz Medical City, Riyadh, Saudi Arabia during the period from January 2015 to December 2021. A chart review was conducted including patients aged 75 years or older, diagnosed with Pulmonary Tuberculosis (PTB), Extra-Pulmonary Tuberculosis (EPT) or Disseminated Tuberculosis (DTB) based on a positive AFB culture, positive TB PCR from sputum, tissues or fluid or compatible histopathological changes, compatible clinical presentation with documented radiological response after starting on anti TB medications. Only patients who were initiated on anti-tuberculous medications were included.\u003c/p\u003e \u003cp\u003eCollected data included patients, age, gender, comorbidities history of TB or contact with active TB patients, use of immune suppressive medications, presenting complains and time interval from the onset of symptoms until confirmation of TB diagnosis (less than 30 days, between 31\u0026ndash;90 days, and more than 90 days)\u003c/p\u003e \u003cp\u003eWe also collected data on initial laboratory investigations, including complete blood count (CBC), inflammatory markers (ESR, CRP), liver function tests (LFT) and renal function tests. Radiological findings of chest x ray and CT chest were obtained from radiological reports.\u003c/p\u003e \u003cp\u003eData pertaining to initial TB treatment was collected. Typical initial regimen is defined as initiating therapy with 4 drugs namely Isoniazid, Rifampicin, Pyrazinamide and Ethambutol (RIPE regimen). Atypical initial therapy regimen is defined as any modification of the previously mentioned drugs either by substitution or omission of one or more drugs. Any modification of the initial regimens was documented including the indication for the modification, nature of modification (omission, addition, or substitution of drugs). Outcome of TB therapy was documented.\u003c/p\u003e \u003cp\u003eThe study received ethical approval from the Ethics Committee at King Abdullah International Medical Research Center (KAIMRC) under approval number \u003cb\u003eIRB/2609/22\u003c/b\u003e.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eA comprehensive statistical analysis was conducted on the dataset, encompassing both descriptive and inferential methodologies. Firstly, a descriptive analysis is conducted to summarize the demographic characteristics of the participants, which include age, gender, and other features. This provides an overview of the study population. Subsequently, inferential analyses such as Fisher\u0026rsquo;s Exact Test or ANOVA (for more than two groups) are employed to examine the significant difference between variables. Binary Logistic Regression is used to find out the predictors of delayed diagnosis and mortality as outcome. Statistical significance is established at a p-value of 0.05 or lower and a 95% Confidence Interval. All statistical analyses are executed using IBM's SPSS Software, version 29.0.0.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003eDemographic and presenting symptoms:\u003c/h2\u003e\n \u003cp\u003eWe identified 92 patients with TB, most were male, 40 patients (76.1%). The mean age was 82.5\u0026thinsp;\u0026plusmn;\u0026thinsp;6.8 years. Forty-eight patients were diagnosed as PTB (52.2%), 30 patients as EPTB (32.6%) and 14 patients (15.2%) were diagnosed as DTB. Spinal tuberculosis was the most common extrapulmonary form of Tuberculosis occurring in 12 patients followed by TB lymphadenitis in 7 patients. (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eThe most common presenting symptoms were cough in 47 patients (51.1%), fever in 40 patients (43.5%), dyspnea in 36 patients (39.1%), weight loss in 29 patients (31.5%), night sweats in 15 patients (16.3%), and hemoptysis in 9 patients (9.8%). Additionally, 55 patients (59.8%) exhibited other symptoms like poor oral intake and low back pain. (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) The time interval from symptom onset to diagnosis varied. In 33 patients (35.9%), diagnosis of TB was established\u0026thinsp;\u0026le;\u0026thinsp;30 days from start of symptoms, 30 patients (32.6%) diagnosis was confirmed 31\u0026ndash;90 days from symptoms, and in 29 patients (31.5%) diagnosis was established after 3 months of symptoms. (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eThe most prevalent comorbidity was Diabetes Mellitus (DM) in 55 patients (59.8%) and Congestive Heart Failure (CHF) in 38 patients (41.3%). Other comorbidities include chronic kidney disease (CKD) in 23 patients (25%), Hemodialysis in 10 patients (10.9%), Chronic Liver Disease (CLD) in 6 patients (6.5%) and chronic respiratory disease (Asthma and COPD) in 4 patients (4.3%). Seven patients were immunocompromised or on Immunosuppressive Therapy (7.6%). History of prior TB was present in 8 patients (8.7%). History of recent contact with TB was documented on 4 patients (4.3%). (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eLogistic regression analysis identifying adjusted predictors of delay in the diagnosis of tuberculosis (TB). Weight loss has a significant positive association with delay (B\u0026thinsp;=\u0026thinsp;1.991, p\u0026thinsp;=\u0026thinsp;0.003), with an odds ratio (Exp (B)) of 7.322, indicating that elderly individuals experiencing weight loss are approximately 7 times more likely to face delayed TB diagnosis. Furthermore, gender (male) also demonstrates significance (B=-1.379, p\u0026thinsp;=\u0026thinsp;0.030), with an odds ratio of 0.252, suggesting that males have a lower likelihood of delayed diagnosis compared to females. Other symptoms and age did not show significant associations. (Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003eInitial Labs, and Radiological findings\u003c/h2\u003e\n \u003cp\u003eDifferent Laboratory findings according to different types of TB shown in Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. Patients with DTB had significantly more eosinophilia (defined as eosinophil count more than \u0026ge;\u0026thinsp;500cells/mcL) compared to those with PTB or EPTB (\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.026\u003c/em\u003e). Thrombocytopenia (defined as Platelet count of \u0026lt;\u0026thinsp;150 cells/mcL) was also significantly more prevalent in patients with DTB (\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.003\u003c/em\u003e). The mean C-reactive protein and Albumin levels were significantly lower in patients with PTB compared to patient with DTB or EPTB. (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eThe most prevalent radiological findings in Tuberculosis in this group is shown in figure (1). Consolidation was present in 47 patients (51.1%), Upper Lung lobe involvement occurred in 46 patients (50%) while lower lobe involvement was present in 31 patients (33.7%). Middle lobe involvement was present in 17 patients (18.5%). Pleural Effusion was present in 46 patients (50%). Lymph node enlargement was present in 39 patients (42.4%). Other common findings include ground glass opacity in 20 patients (21.7%), and cavitation in 19 patients (20.7%) (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003eDiagnosis, and Treatment\u003c/h2\u003e\n \u003cp\u003eThe diagnosis of TB was confirmed by a positive culture in 50 patients (54%), by PCR alone in 2 patients (2.2%), while diagnosis was based on a histological finding compatible with TB (granuloma) in 36 patients (39%). Clinical diagnosis of TB without confirmatory tests was made in 4 patients (4.3), all of whom were started on Anti-TB therapy and showed clinical and radiological response (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eTypical initial RIPE regimen was used in 82 patients (89.1%) while an initial modified regimen was used in 17 patients (28.3%). Treatment adjustment within the first 2 months occurred in 24 patients (26.1%). The most frequent reason to modify an initial typical 4 drug regimen was increase in liver enzymes (ALT) occurring in 18 patients (20.7%). Other adverse reactions include skin rashes and gastro-toxicity reported in 3, and 3 patients respectively (3.3%). Thrombocytopenia is the least frequently reported adverse effect, affecting one patient (1.1%) of patients. (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003ePZA was the most common cause of altered liver enzymes, in 10 of the 18 patients (55.5%), followed by INH and Rifampicin, in 2 patients each. In the other 4 patients, both INH and PZA were stopped concomitantly and were never restarted again. Other causes of modifications were poor compliance in two patients and anaphylaxis reaction in one patient (PZA was blamed).\u003c/p\u003e\n \u003cp\u003eIn two additional patients, same initial drugs were continued but more drugs were added because of worsening symptoms. Side effects\u003c/p\u003e\n \u003cp\u003ePyrazinamide was the most frequently discontinued drug from initial regimen in 14 patients (15%) and Moxifloxacin was the most frequently introduced medication in 15 patients (16.3%) patients followed by Amikacin in 4 patients and Linezolid in one patient. INH and Rifampicin were replaced in 6 (6.5%) and 8 patients (8.7%) respectively. (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eInitial modified regimen was used in 17 patients. Two of the initial RIPE drugs were substituted in one patient and 3 drugs were all substituted in another 3 patients (3%). In two patients, the whole 4 drugs were stopped together for transaminases and then re-started again with no increase in liver enzymes with the re-challenge. In three patients, only omission of one drug was done and three drugs only were used in treatment for the initial two months of therapy.\u003c/p\u003e\n \u003cp\u003eThe most frequent initial atypical TB treatment regimen was a 4-drug regimen with Ethambutol, Moxifloxacin, Rifampicin and Isoniazid in 3 patients, and a 3-drug regimen with Ethambutol, INH and wither Moxifloxacin or Rifampicin in 4 patients. Moxifloxacin was the most frequently used drug from the second line agents. Modification due to resistant strain only occurred in one patient (1.1%)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eOutcome\u003c/h2\u003e\n \u003cp\u003eSuccessful completion of intended TB therapy (cure) was achieved in 53 patients (67.6%). Twenty-two patients died during TB therapy (23.9) while follow up was lost during therapy in 17 patients (18.5%). Causes of death was respiratory failure in 8 patients (8.7%), septic shock with multi-organ failure in 7 patients (7.6%). No documented reason of death in 7 patient (7.6%). (Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003ePredictors of mortality in TB among elderly patients include the significant negative association of fever (B=-2.532, p\u0026thinsp;=\u0026thinsp;0.032) and lower lobe involvement (B=-2.199, p\u0026thinsp;=\u0026thinsp;0.036). Conversely, night sweats (B\u0026thinsp;=\u0026thinsp;1.288, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.428\u003c/em\u003e), hemoptysis (B\u0026thinsp;=\u0026thinsp;1.750, p\u0026thinsp;=\u0026thinsp;0.084) and Ground glass opacity (B=-2.521, p\u0026thinsp;=\u0026thinsp;0.045) demonstrate positive associations with higher mortality (Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e). Patients with pulmonary tuberculosis has higher mortality compared to those with extrapulmonary tuberculosis both during TB therapy and after completion of treatment (p\u0026thinsp;=\u0026thinsp;0.007 and p\u0026thinsp;=\u0026thinsp;0.019).\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eDespite a decreasing incidence of newly diagnosed TB cases in many parts of the world including Saudi Arabia, incidence of tuberculosis in older persons (aged\u0026thinsp;\u0026ge;\u0026thinsp;65 years) still constitute a significant proportion of all notified TB cases [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In Japan and Korea, 69% and 51 of newly diagnosed TB cases were in patient aged 65 and older [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In Western Pacific Region, Tuberculosis in the elderly was 19.5%, the highest of the total TB incidence in that region [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Tuberculosis also remains a leading cause of death worldwide, with older age recognized as a major risk factor for TB-related death [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. We aimed in this study to evaluate the profile and outcomes of TB in the elderly in Saudi Arabia, which is still considered a country with a moderate burden of Tuberculosis.\u003c/p\u003e \u003cp\u003eTuberculosis in elderly is usually secondary to reactivation especially in countries with lower TB burden [\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Progression of a primary TB infection or reactivation of TB may also occur in elderly due to age-associated immune dysfunction and associated comorbidities especially in countries with high TB burden and transmission [\u003cspan additionalcitationids=\"CR21 CR22 CR23\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. In our study the majority of our patients had underlying comorbidities and we believe the reactivation is the most likely mechanism of TB disease in this group. Only 4 of our patients (4.3%) gave a history of recent exposure to confirmed TB cases.\u003c/p\u003e \u003cp\u003eFifty-five of our patients (59.8%) presented with less specific symptoms such as fatigue, back pain, and low oral intake. The typical clinical presentation of tuberculosis like prolonged cough, hemoptysis and weight loss may be less prominent in elderly persons. The presenting symptoms and signs may also be confounded by concurrent comorbidities including structural lung disease like COPD, making TB more challenging to diagnose in older adults and leading to delay in diagnosis or even misdiagnosis with malignancies for example. Patients may also dismiss some of the symptoms like cough attributing it to other illness common in older people like COPD [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR26 CR27 CR28 CR29\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. More than two thirds of patients ultimately diagnosed with Tuberculosis were not recognized on initial hospitalization; the majority (64%) of those with initial missed diagnosis were aged\u0026thinsp;\u0026gt;\u0026thinsp;60 years [\u003cspan additionalcitationids=\"CR32\" citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThere was a delay of 3 months or more before the diagnosis was established in more than one third of our patients. In a study done in China, the median time from symptom onset to TB disease diagnosis was \u0026gt;\u0026thinsp;90 days among older adults [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Delay in diagnosis will result in more advanced disease at time of diagnosis, more likelihood of transmission and potentially higher mortality. This delay in diagnosis may be a factor contributing to high mortality observed in our study.\u003c/p\u003e \u003cp\u003eSome of the symptoms like weight loss may miss guide the physicians to malignancy. In our study, weight loss was significantly associated with delayed diagnosis. Inadequate TB awareness and knowledge about TB in elderly has been reported in some countries [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Interventions designed to explore the awareness and knowledge about TB disease and its symptoms in older Saudi citizens is warranted.\u003c/p\u003e \u003cp\u003eRadiological features of TB in older people may be different than in younger population. Various studies reported less prevalence of typical lung cavitation, consolidation or pulmonary nodules [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan additionalcitationids=\"CR37 CR38\" citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] In our study however, both cavity lung disease, upper lobe involvement and pleural effusion occurs in half of the patientsLower lobe involvement and nodular changes were less commonly present compared to other reports [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSelecting a regimen for treatment of TB in older people may also be challenging for many reasons. Polypharmacy and drug to drug interactions with TB medications is common in elderly due to multiple coexisting illness [\u003cspan additionalcitationids=\"CR55\" citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]. The two main first line medication, INH and in particular Rifampicin is associated with drug-to-drug interaction like with the anticoagulants DOAC and warfarin.\u003c/p\u003e \u003cp\u003eOlder people with TB above age of 85 years have a higher risk of treatment failure and a higher rate of treatment interruption due to side effects [57, 58]. There was no documentation of treatment failure in our group, however modifications of initial regimens were due to worsening symptoms in two patients only.\u003c/p\u003e \u003cp\u003eAdverse effects of TB medication in elder are also a significant concern. All the three first line drug therapy for TB. INH, rifampicin and pyrazinamide are associated with hepatoxicity in elderly [\u003cspan additionalcitationids=\"CR43\" citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. In elderly people, pyrazinamide omission from the initial regimen is suggested by some authors to avoid toxicity [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. American guideline does not recommend the use of pyrazinamide during the intensive phase in elderly above 75 years with moderate disease and lower resistance risk [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Other studies, however, did not find an association between PZA containing regimens use and higher treatment discontinuation rates, liver toxicity, or death in older people [\u003cspan additionalcitationids=\"CR46\" citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. WHO has not recommended any specific TB treatment regimen in the elderly.\u003c/p\u003e \u003cp\u003ePZA is not the only anti TB medication that pose a problem in eldest [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. Although Elderlies are more likely to have vision related medical problems which increase potential toxicity of Ethambutol[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Ethambutol side effects were not reported frequently in our patients, significant side effects from this medication were common in elderly people in some other studies. There was no documentation of routine visual acuity assessment in patients taking this medication in our study. Two of the most commonly used (so called second line therapy) anti-TB agents are Moxifloxacin and Linezolid. Moxifloxacin is being increasingly incorporated as part of initial regimen. The drug has a high risk of hepatic toxicity, QT prolongation and tendinitis in older people[\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Safety of linezolid use in elderly in older people is not well known [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]. Linezolid has been used in few of our patients.\u003c/p\u003e \u003cp\u003eDrug resistance in our population was very low. This was similarly shown in other parts of the world. In Germany, resistance rate of all anti TB medication was lower in older persons (6.5 vs. 13.9%) including those with multi resistant isolates (MDR) (0.6 vs. 3.1%) [59]. in another cohort of more than 3000 patients from China, primary TB cases in elderly had a lower rate of drug resistant TB, multi drug resistant TB, Rifampin resistance TB and streptomycin resistant TB. Resistance to INH and Ethambutol however was higher among elderly [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eLimitation\u003c/h3\u003e\n\u003cp\u003eThis is a single center study and results may be limited to this geographical location. The large number of patients lost to follow could have affected the mortality rate. Many of the lost follow ups are likely dead. This conclusion is made because all of the patients in this group are Saudi citizens who have full eligibility in this tertiary center and are very unlikely to seek heath care elsewhere at their age. Loss of follow up is not uncommon in elderly with TB [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe also did not assess adherence to medications which was found to be a problem in some other studies [\u003cspan additionalcitationids=\"CR56\" citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe diagnosis and treatment of tuberculosis (TB) in elderly patients (over 75 years) presents a significant challenge. Nonspecific symptoms, delays in diagnosis, and frequent adverse reactions to medications all contribute to this complexity. A critical reevaluation of current diagnostic and therapeutic approaches is warranted. Existing literature suggests concerning trends: frequent modifications to initial drug regimens, often lacking robust evidence and potentially reflecting physician bias. While establishing a association between TB infection and mortality in elderly can be difficult, further targeted research is essential to define the most efficacious treatment strategies for this group of patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe Institutional Review Board at King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia (\u003cstrong\u003eIRB/2609/22\u003c/strong\u003e), approved the study. Patient confidentiality was ensured, and the collected patients\u0026apos; data used by the research team only\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: All authors agree for publication\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e: available\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e : none\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e: None\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e: none\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eSB: Supervision of the research Conception and design of Study, participate in writing the draft and final manuscriptAA :Collecting , Acquisition of data HR: Collecting , Acquisition of data HJ : Conception the study , participate in writing the final manuscriptLL : Analysis and interpretation of dataES: Literature review , review and reference updateAll authors have critically reviewed the manuscript for important intellectual contents, approved the final draft and are responsible for the content and similarity index of the manuscript\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eW. 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Leung\u003cem\u003e et al.\u003c/em\u003e, \u0026quot;Tuberculosis in older people: a retrospective and comparative study from Hong Kong,\u0026quot; (in eng), \u003cem\u003eJ Am Geriatr Soc, \u003c/em\u003evol. 50, no. 7, pp. 1219-26, Jul 2002, doi: 10.1046/j.1532-5415.2002.50308.x.\u003c/li\u003e\n\u003cli\u003eS. Bele\u003cem\u003e et al.\u003c/em\u003e, \u0026quot;Population aging and migrant workers: bottlenecks in tuberculosis control in rural China,\u0026quot; \u003cem\u003ePLoS One, \u003c/em\u003evol. 9, no. 2, p. e88290, 2014.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e: Sociodemographic parameters, prevalence of different TB types and presenting symptoms\u003c/p\u003e\n\u003cp\u003e\u003cimg 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\" width=\"688\" height=\"652\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e^ TB peritonitis, Testicular TB and chest wall TB\u003c/p\u003e\n\u003cp\u003e* Decrease level of consciousness, confusion\u003c/p\u003e\n\u003cp\u003e** Fatigue, malaise, decrease oral intake.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e*** Induced sputum, bronchoscopic lavage\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: -\u003c/strong\u003e Adjusted predictors of delay in diagnosis of TB (Logistic Regression Analysis\u003cs\u003e)\u0026nbsp;\u003c/s\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"638\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.078369905956112%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.890282131661442%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.047021943573668%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSig.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.047021943573668%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eExp(B)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.937304075235108%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.933\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e1.072\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender (Male)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e-1.379\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e.030\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.872\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDyspnea\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e.301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.644\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e1.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e4.847\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCough\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e-.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.817\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.858\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e3.133\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFever\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e-.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.933\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.957\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.341\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e2.685\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNight Sweat\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.912\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e1.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e5.859\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHemoptysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e-.201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e4.527\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeight Loss\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e1.991\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e.003\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e7.322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e1.924\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e27.858\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOthers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e.806\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e2.238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.764\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e6.559\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"25.039123630672925%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eConstant\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.86697965571205%\" valign=\"top\"\u003e\n \u003cp\u003e.619\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e.836\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e1.856\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.023474178403756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3:\u0026nbsp;\u003c/strong\u003eDifferent laboratory finding according to different type of TB (ANOVA)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"703\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePulmonary TB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eExtra-Pulmonary TB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisseminated TB\u0026lrm;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSig.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eValue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.162291169451073%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.389021479713605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.389021479713605%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.05966587112172%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhite Blood Cell Count\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e10.96 (16.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e8.17 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e5.30 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e9.15 (12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.275\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLymphocyte\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e17.34 (9.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e22.70 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e18.71 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e19.12 (11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePolymorph Neutrophils\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e65.21 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e60.73 (15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e55.69 (28.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e62.46 (19.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.377\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEosinophils\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e1.63 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e.80 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e13.93 (33.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e3.28 (13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e0.026\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHemoglobin\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e115.52 (20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e118.13 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e103.57 (17.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e114.53 (19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHematocrit\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e0.36 (0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e0.35 (0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e0.32 (0.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e0.35 (0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlatelets\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e299.78 (135.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e315.55 (117.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e176.57 (111.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e285.54 (133.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e0.003\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eErythrocyte Sedimentation Rate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e83.92 (29.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e81.19 (28.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e71.11 (42.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e80.87 (30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.569\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eC reactive protein\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e95.22 (71.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e48.86 (32.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e109.53 (72.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e80.09 (63.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e0.009\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eProcalcitonin\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e0.17 (0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e2.52 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e0.38 (0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e1.39 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlkaline Phosphatase\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e154.89 (106.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e162.03 (108.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e161.29 (146.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e158.22 (113.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.960\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGamma-glutamyl transpeptidase\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e190.45 (157.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e214.28 (229.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e178.50 (123.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e198.82 (183.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAspartate Aminotransferase\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e33.57 (23.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e35.86 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e38.79 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e35.13 (23.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.760\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlanine Aminotransferase\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e24.85 (18.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e30.66 (34.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e24.93 (11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e26.75 (24.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlbumin\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e28.76 (7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e32.04 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e26.14 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e29.41 (7.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e0.026\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Bilirubin\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e12.68 (9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e11.32 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e14.46 (11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e12.51 (9.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood Urea Nitrogen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e7.78 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e7.76 (5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e9.30 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e8.01 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.606\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUric Acid\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e294.35 (152.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e308.64 (125.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e311.33 (207.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e301.63 (151.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.903\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.91168091168091%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCreatinine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.80911680911681%\" valign=\"top\"\u003e\n \u003cp\u003e126.56 (172.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e139.47 (170.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.96011396011396%\" valign=\"top\"\u003e\n \u003cp\u003e142.07 (133.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.957264957264957%\" valign=\"top\"\u003e\n \u003cp\u003e133.35 (164.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.401709401709402%\" valign=\"top\"\u003e\n \u003cp\u003e0.926\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4:\u003c/strong\u003e Treatment related Features of TB Patients\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"682\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"72.47437774524158%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=\u003c/strong\u003e92\u003cstrong\u003e)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.058651026392962%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment Duration\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePatients who completed therapy\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePatients died during therapy \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.52199413489736%\" valign=\"top\"\u003e\n \u003cp\u003eMonths (Mean, SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.419354838709676%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e7.1 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.79664570230608%\" valign=\"top\"\u003e\n \u003cp\u003eDays (Mean, SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"39.20335429769392%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e12.1 (7.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInitial Regimen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003eTypical Regimen (Ethambutol/Pyrazinamide/Rifampin/Isoniazid)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e89.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.66945606694561%\" valign=\"top\"\u003e\n \u003cp\u003eModified Regimen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.96652719665272%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.364016736401673%\" valign=\"top\"\u003e\n \u003cp\u003e10.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjustment of Initial Treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e26.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eChanges due to Resistance\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRechallenged Initial Regimen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFinal Regimen\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003eTypical Regimen (Ethambutol/Pyrazinamide/Rifampin/Isoniazid)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e70.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.66945606694561%\" valign=\"top\"\u003e\n \u003cp\u003eModified Regimen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.96652719665272%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.364016736401673%\" valign=\"top\"\u003e\n \u003cp\u003e29.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdverse Reaction due to Treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e19.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome of Treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003eComplete therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e57.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.66945606694561%\" valign=\"top\"\u003e\n \u003cp\u003eDied during before completion of therapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.96652719665272%\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.364016736401673%\" valign=\"top\"\u003e\n \u003cp\u003e23.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.66945606694561%\" valign=\"top\"\u003e\n \u003cp\u003eDied after completion of therapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.96652719665272%\" valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.364016736401673%\" valign=\"top\"\u003e\n \u003cp\u003e17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.66945606694561%\" valign=\"top\"\u003e\n \u003cp\u003eLost Follow-Up during treatment\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.96652719665272%\" valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.364016736401673%\" valign=\"top\"\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.66945606694561%\" valign=\"top\"\u003e\n \u003cp\u003eLost follow up after treatment completion\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.96652719665272%\" valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.364016736401673%\" valign=\"top\"\u003e\n \u003cp\u003e17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCauses of death during therapy\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003eRespiratory Failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e8.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.66945606694561%\" valign=\"top\"\u003e\n \u003cp\u003eSeptic Shock with MOF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.96652719665272%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.364016736401673%\" valign=\"top\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"60.66945606694561%\" valign=\"top\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.96652719665272%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.364016736401673%\" valign=\"top\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.01464128843338%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCauses of death after completion of therapy\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"42.4597364568082%\" valign=\"top\"\u003e\n \u003cp\u003eCardiovascular even\u003c/p\u003e\n \u003cp\u003ePneumonia (bacterial, Viral)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMalignancy\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLiver cirrhosis\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUnknown\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.373352855051245%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.152269399707174%\" valign=\"top\"\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5: -\u003c/strong\u003e Adjusted predictors of poor outcome (Mortality) in TB (Logistic Regression Analysis)\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"641\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSig.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eExp(B)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.2808112324493%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"49.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e1.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.956\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e1.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u0026nbsp;(Male)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.734\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e1.373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e8.523\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresentin\u003c/strong\u003e\u003cstrong\u003eg\u0026nbsp;Features\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCough\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.381\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e2.591\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e21.790\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFever\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e-2.532\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e.032\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e.806\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDyspnea\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e-1.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.229\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e1.925\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeight Loss\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e-1.059\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.461\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e5.776\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNight Sweats\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e1.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e3.627\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e87.636\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHemoptysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e1.750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e5.756\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.793\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e41.799\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of Other Symptoms\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e-1.451\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.036\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e1.512\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePathological Features\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eConsolidation\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e1.403\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e4.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.462\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e35.802\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper Lung Lobe Involvement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.791\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.440\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e2.207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e16.422\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePleural\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Effusion\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e1.128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e3.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e19.100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLymph\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Node Enlargement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e-.455\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.705\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.634\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.060\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e6.713\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower Lobe Involvement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e-2.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e.036\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e.869\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNodules\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e1.382\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e3.984\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.346\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e45.808\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGround\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Glass Opacity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e-2.521\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e.045\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e.948\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCavitation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e-.720\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.463\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.487\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e3.328\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"45.08580343213728%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMiddle Lung Lobe Involvement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.835\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e1.262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e.141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e11.315\u003c/p\u003e\n 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width=\"11.232449297971918%\" valign=\"top\"\u003e\n \u003cp\u003e.249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.168486739469579%\" valign=\"top\"\u003e\n \u003cp\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.29641185647426%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.98439937597504%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-epidemiology-and-global-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Epidemiology and Global Health](https://www.springer.com/journal/44197)","snPcode":"44197","submissionUrl":"https://submission.nature.com/new-submission/44197/3","title":"Journal of Epidemiology and Global Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Tuberculosis, Elderly, TB in Saudi, mortality, Disseminated Tuberculosis","lastPublishedDoi":"10.21203/rs.3.rs-4167985/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4167985/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTuberculosis is a significant contributor of morbidity and mortality. With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical, radiological features, treatment and outcome of TB in patients aged 75 years or older was evaluated retrospectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p=0.007).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTuberculosis is associated with high mortality in patients above age of 75. There is still a substantial delay in TB diagnosis in elderly. RIPE regimen is frequently changed due to side effect. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient’s population is needed to define the best effective therapeutic approach.\u003c/p\u003e","manuscriptTitle":"Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 years and Older","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-05 16:31:19","doi":"10.21203/rs.3.rs-4167985/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-04-21T21:10:49+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-04-21T18:00:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-04-13T13:47:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"6731a42b-a8f1-4698-9805-9af4ed5aa131","date":"2024-04-11T08:09:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"70a65b87-2cf2-431f-b429-00efdaf762d3_SNPRID","date":"2024-04-10T12:39:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"65a467e2-4677-4ffd-90cd-2a21ee7e4e6a","date":"2024-04-10T12:22:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-04-06T06:49:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"38044973-611d-4f2a-9117-fef002c6dab8","date":"2024-04-05T01:22:02+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-04-04T20:36:39+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-04-04T20:30:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-03T03:23:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Epidemiology and Global Health","date":"2024-03-26T07:51:56+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-epidemiology-and-global-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Epidemiology and Global Health](https://www.springer.com/journal/44197)","snPcode":"44197","submissionUrl":"https://submission.nature.com/new-submission/44197/3","title":"Journal of Epidemiology and Global Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5fb253a2-e904-45d5-bcdb-007fd073d343","owner":[],"postedDate":"April 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-09-26T16:23:38+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-05 16:31:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4167985","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4167985","identity":"rs-4167985","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}