Background: Geriatric tuberculosis (GT) represents a growing public health challenge, complicated by atypical presentations and high mortality. Comorbidity and polypharmacy are ubiquitous in the elderly but their specific impact on TB outcomes in regions like the Fergana Valley, Uzbekistan, is poorly documented. Aim: To evaluate the clinico-epidemiological significance of comorbidity and polypharmacy on the diagnosis, management, and outcomes of geriatric tuberculosis in the Fergana Valley. Methods: A retrospective and prospective cohort study was conducted at the Andijan Regional Phthisiology and Pulmonology Center, analyzing medical records of patients aged 60 and over diagnosed with TB between 2020 and 2024. Data on comorbidities (e.g., cardiovascular disease (CVD), diabetes mellitus (DM)), and polypharmacy (defined as 5+ non-TB drugs) were collected. Statistical analysis employed Chi-square (S2) and Mann-Whitney U tests to assess associations with adverse drug reactions (ADRs) and treatment outcomes. Results: Of the 240 patients analyzed (mean age 68.2 ± 6.1 years), 85% (n=204) had at least one comorbidity, with CVD (75%) and DM (42.1%) being most prevalent. Polypharmacy was present in 65% (n=156) of patients. Polypharmacy was significantly associated with a higher incidence of ADRs (48.7% vs. 20.2%, p<0.001). Uncontrolled DM and polypharmacy were independent predictors of unsuccessful treatment outcomes (p<0.05). Conclusion: Comorbidity and polypharmacy are central, not peripheral, challenges in managing geriatric TB in the Fergana Valley. They are significantly associated with increased ADRs and poorer treatment success, highlighting the need for integrated geriatric-focused TB care and proactive medication management.

Geriatric tuberculosis, comorbidity, polypharmacy, elderly, risk factors, treatment outcomes, Fergana Valley.

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