Post tuberculosis radiological sequelae in patients treated for pulmonary and pleural tuberculosis at a tertiary center in Pakistan

Abstract

Treating tuberculosis (TB) is not the end of the disease because of the wide spectrum of post TB sequelae associated with the disease. There is insufficient data on post TB radiological sequelae. The aim of this study is to evaluate the post TB radiological sequelae on chest x-rays in patients who had completed the treatment for pulmonary and pleural TB at a tertiary care hospital of a high TB burden country. This is a retrospective cross-sectional study conducted on patients treated for pulmonary and pleural TB. Adult patients (18 years or above) with a clinical or microbiological diagnosis of pulmonary or pleural TB were included. Patients were classified on the basis of site of TB into pulmonary and pleural TB. Post-treatment radiological sequelae on chest x-ray were evaluated and divided into three main types i.e. fibrosis, bronchiectasis and pleural thickening. During the study period a total of 321 patients were included with a mean age of 44(SD±19) years. Only 17.13% (n=55) patients had normal chest x-rays at the end of treatment and 82.87% (n=266) patients had post-TB radiological sequelae with fibrosis being the most common followed by pleural thickening. The post TB radiological sequelae were high in patients who had diabetes mellitus (78.94%), AFB smear-positive (90.19%), AFB culture-positive (89.84%), Xpert MTB/Rif positive (88.40%) and with drug-resistant TB (100%). As a clinician, one should be aware of all the post TB sequelae so that early diagnosis and management can be facilitated.

Post Tuberculosis (TB) Bronchiectasis versus Non-TB Bronchiectasis in Northern Pakistan: A single centre retrospective cohort study on frequency, demographics, microbiology, and complications

“…Pakistan has the 5 th highest burden of Tuberculosis (TB) world-wide and accounts for 61% of new TB cases in the WHO Eastern Mediterranean Region (13). While a national TB control programme has long existed, there are delays in diagnosis and treatment resulting in a relatively static high incidence of TB (14)(15)(16)(17) and increased complications of TB such as bronchiectasis (18). TB is known to be the most common cause of Bronchiectasis in South Asia (7,19) and patients with Post TB Bronchiectasis are known to have more severe disease compared with Non-TB Bronchiectasis (5,(20)(21)(22)(23).…”

“…TB is known to be the most common cause of Bronchiectasis in South Asia (7,19) and patients with Post TB Bronchiectasis are known to have more severe disease compared with Non-TB Bronchiectasis (5,20–23). However, there has been little research into its prevalence, microbiology, or complications in Pakistan(8,18). In this single-centre retrospective cohort study at Bach Christian Hospital (BCH) in rural Northern Pakistan, we seek to explore the frequency of TB as a cause of Bronchiectasis, demographics, as well as the microbiology and associated complications in TB versus Non-TB Bronchiectasis.…”