西太平洋区域是全球老年人(≥65岁)人口增长最快的地区之一。其中结核病(TB)引起特别关注。本研究报告了来自中国的国家案例研究,Japan,大韩民国,和新加坡反思他们在老年人结核病管理方面的经验。
在所有四个国家,结核病病例通报和发病率在老年人中最高,但针对该人群的临床和公共卫生指导有限.个别国家报告说明了一系列做法和挑战。被动发现案件仍然是常态,在中国实施了有限的主动病例发现(ACF)计划,Japan,和大韩民国。已经尝试了不同的方法来帮助老年人确保早期诊断,以及坚持他们的结核病治疗。所有国家都强调需要以人为本的方法,包括创造性应用新技术和量身定制的激励计划,以及我们如何提供治疗支持的重新概念化。发现传统药物的使用在文化上根深蒂固,在老年人中,需要仔细考虑它们的补充使用。在高度可变的实践中,未充分利用结核病感染测试和结核病预防性治疗(TPT)。
老年人在结核病应对政策中需要特别考虑,鉴于人口老龄化和高结核病风险。政策制定者,结核病计划和资助者必须投资并制定当地背景下的实践指南,为老年人提供基于证据的结核病预防和护理实践。
The Western Pacific Region has one of the fastest-growing populations of older adults (≥ 65 years) globally, among whom tuberculosis (TB) poses a particular concern. This study
reports country
case studies from China, Japan, the Republic of Korea, and Singapore reflecting on their experiences in managing TB among older adults.
Across all four countries, TB
case notification and incidence rates were highest among older adults, but clinical and public health guidance focused on this population was limited. Individual country
reports illustrated a range of practices and challenges. Passive
case finding remains the norm, with limited active
case finding (ACF) programs implemented in China, Japan, and the Republic of Korea. Different approaches have been trialled to assist older adults in securing an early diagnosis, as well as adhering to their TB treatment. All countries emphasised the need for person-centred approaches that include the creative application of new technology and tailored incentive programs, as well as reconceptualisation of how we provide treatment support. The use of traditional medicines was found to be culturally entrenched among older adults, with a need for careful consideration of their complementary use. TB infection testing and the provision of TB preventive treatment (TPT) were underutilised with highly variable practice.
Older adults require specific consideration in TB response policies, given the burgeoning aging population and their high TB risk. Policymakers, TB programs and funders must invest in and develop locally contextualised practice guidelines to inform evidence-based TB prevention and care practices for older adults.