Ambulatory independence is associated with higher incidence of latent tuberculosis infection in long-term care facilities in Taiwan.

Abstract

BACKGROUND/PURPOSE:

Tuberculosis (TB) in the elderly population remains a major challenge in areas with intermediate disease burden like Taiwan. Despite the increasing burden and high risks of TB in the elderly population, particularly those living in long-term care facilities (LTCFs), diagnostic testing for latent tuberculosis infection (LTBI) has not been carefully evaluated in this group. This study aimed to investigate the prevalence and predictors of LTBI in older adults living in LTCFs.

METHODS:

Older adults living in seven LTCFs in Taiwan were prospectively enrolled between January and July 2017. Interferon-gamma release assay (IGRA) through QuantiFERON-TB Gold In-tube was used to determine presence of LTBI. Predictors for LTBI were analyzed.

RESULTS:

A total of 258 participants were enrolled, including 240 older residents (mean age, 81.6 years; male, 51.2%) and 18 employees (mean age, 64.8 years; male, 22.2%). The proportion of independent status in ambulation assessments significantly declined with aging (p < 0.001). The IGRA-positivity rate in LTCFs was 31.4% (81/258), which consisted of 73 (30.4%) residents and 8 (44.4%) employees. The IGRA results were different with respect to the ambulation status (p = 0.052). In the multivariate logistic regression analysis, the only independent predictor of LTBI among older adults in LTCFs was independent ambulation (odds ratio, 2.16; 95% confidence interval, 1.09-4.28; p = 0.027).

CONCLUSIONS:

There was a high prevalence of LTBI among older adults in LTCFs in Taiwan. Independent ambulation was the only independent predictor of LTBI.

• Authors: Shang-Yi Lin, Jung-Yien Chien, Hsiu-Tzy Chiang, Min-Chi Lu, Wen-Chien Ko, Yen-Hsu Chen, Po-Ren Hsueh
• Journal: Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi (J Microbiol Immunol Infect) Vol. 54 Issue 2 Pg. 319-326 (Apr 2021) ISSN: 1995-9133 [Electronic] England
• PMID: 31624017 (Publication Type: Journal Article)
• Copyright: Copyright © 2019. Published by Elsevier B.V.

Topics

• Activities of Daily Living
• Aged
• Aged, 80 and over
• Cross-Sectional Studies
• Diagnostic Tests, Routine
• Female
• Health Facilities
• Humans
• Incidence
• Interferon-gamma Release Tests (methods)
• Latent Tuberculosis (diagnosis, epidemiology)
• Long-Term Care
• Male
• Nursing Homes
• Odds Ratio
• Prevalence
• Taiwan (epidemiology)
• Tuberculin Test
• Tuberculosis (complications)
• Walking