We cannot end TB if we leave the older people behind

Shobha Shukla
Contd from previous issue
chronic kidney diseases, chronic obstructive pulmonary disease, and malignancy. A strong connection has been established between diabetes and TB among the elderly,” said Dr Arora.
“Moreover, immunity declines with old age. As immunity wanes, many cases appear to have links to the reactivation of lesions that had remained dormant over many years. The susceptibility to the disease is also increased in the background of malnutrition, chronic alcoholism, pollution, unhygienic living conditions and smoking. Also, drug-resistant TB strains put great hurdles to achieve successful treatment outcomes,” he added.
Pneumonia, invasive pneumococcal disease and other lung diseases
Community acquired pneumonia in winters and invasive pneumococcal disease in un-immunised people pose a challenge. Opportunistic bacterial, fungal, viral, and parasitic infections in the elderly are not only difficult to diagnose but also difficult to treat. Further, there are many potential interactions between anti-TB drugs and other additional medications used by the elderly for the management of co-existing diseases.
According to a study, an all-inclusive management that includes geriatricians and infectious disease specialists, is required in these vulnerable patients, said Dr Arora. Health systems equipped with integrated services will have to address the challenge of an ageing population. Early screening and initiation of treatment along with nutritional management are essential to tackle TB in the elderly. Partnerships between organizations are essential for better management of cases.
Dr VK Arora said that “India is progressing towards delivering on the promise to end TB in the next 45 months (by 2025). It is evident that every person with TB needs to be reached with a full spectrum of TB services, including TB prevention, diagnostics, treatment, care and support. We cannot leave behind the elderly – or other TB vulnerable groups.”
Giving due importance to TB prevention, active case finding and adhering to treatment among the elderly will go a long way to exert positive influence for proper management of TB in the elderly to #endTB.
(Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media).
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