Adolescents and young adults with tuberculosis in low-incidence setting
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
BACKGROUND
Adolescents and young adults (AYA) with TB have distinct physical and social characteristics compared to other age groups. This study describes a cohort of AYA with TB in a low TB-prevalence, high-income setting and investigates whether demographic or social factors affect management outcomes.
METHODS
A retrospective cohort study was conducted at a TB referral centre in North West London, including patients aged 10–24 years from 2015 to 2022. Median days from symptom onset to healthcare presentation were determined and risk factors for late presentation (>60 days) were assessed.
RESULTS
Among 158 patients (median age 20 years, IQR 17–23), 53.6% had pulmonary TB, 39.9% extrapulmonary disease, and 5.7% disseminated disease; 25.3% had cavities. Social risk factors were present in 32.3% of patients. Median delay to presentation was 45 days (IQR 14–96), with 38.7% presenting after two months. Delays were longer in patients with incarceration, drug misuse, or mental health issues, though not statistically significant. Patients with social risk factors were more likely to receive observed therapy (OR 2.65, IQR 1.27–5.64).
CONCLUSIONS
AYA with TB in this setting experienced delays in healthcare presentation and a quarter had cavitary disease. Social risk factors were common but not significantly related to outcomes.
Adolescents and young adults (AYA) with TB have distinct physical and social characteristics compared to other age groups. This study describes a cohort of AYA with TB in a low TB-prevalence, high-income setting and investigates whether demographic or social factors affect management outcomes.
METHODS
A retrospective cohort study was conducted at a TB referral centre in North West London, including patients aged 10–24 years from 2015 to 2022. Median days from symptom onset to healthcare presentation were determined and risk factors for late presentation (>60 days) were assessed.
RESULTS
Among 158 patients (median age 20 years, IQR 17–23), 53.6% had pulmonary TB, 39.9% extrapulmonary disease, and 5.7% disseminated disease; 25.3% had cavities. Social risk factors were present in 32.3% of patients. Median delay to presentation was 45 days (IQR 14–96), with 38.7% presenting after two months. Delays were longer in patients with incarceration, drug misuse, or mental health issues, though not statistically significant. Patients with social risk factors were more likely to receive observed therapy (OR 2.65, IQR 1.27–5.64).
CONCLUSIONS
AYA with TB in this setting experienced delays in healthcare presentation and a quarter had cavitary disease. Social risk factors were common but not significantly related to outcomes.
Date Issued
2025-06-01
Date Acceptance
2025-02-06
Citation
International Journal of Tuberculosis and Lung Disease, 2025, 2 (6), pp.333-338
ISSN
1027-3719
Publisher
International Union Against Tuberculosis and Lung Disease
Start Page
333
End Page
338
Journal / Book Title
International Journal of Tuberculosis and Lung Disease
Volume
2
Issue
6
Copyright Statement
© 2025 The Authors This is an open access article published by The Union under the terms of the Creative Commons Attribution License CC-BY.
License URL
Identifier
10.5588/ijtldopen.25.0031
Subjects
Among 158 patients (median age 20 years
IQR 17-23)
53.6% had pulmonary TB
39.9%
Publication Status
Published