The burden and determinants of post-TB lung disease

Mpagama, Stellah; Msaji, K S; Kaswaga, Oscar Leonard; Zurba, Lindsay; Mbelele, Peter M.; Allwood, Brian; Ngungwa, B-S; Kisonga, Riziki; Lesosky, Maia; Rylance, Jamie; Mortimer, Kevin

doi:10.5588/ijtld.21.0278

Cited by 35 publications

(24 citation statements)

References 34 publications

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“…Up to half of TB survivors have some form of chronic pulmonary dysfunction despite microbiologic cure, impairing their quality of life. 5 – 11 These post-TB consequences are likely to impose a continued financial burden on TB survivors, their families, their communities and the health system. 5 The WHO defines health as a state of ‘complete physical, mental and social well-being’.…”

Section: Post-tb Economic Social and Psychological Wellbeingmentioning

confidence: 99%

Post-TB health and wellbeing

Nightingale

Carlin

Meghji

et al. 2023

int j tuberc lung dis

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TB affects around 10.6 million people each year and there are now around 155 million TB survivors. TB and its treatments can lead to permanently impaired health and wellbeing. In 2019, representatives of TB affected communities attending the ‘1st International Post-Tuberculosis Symposium´ called for the development of clinical guidance on these issues. This clinical statement on post-TB health and wellbeing responds to this call and builds on the work of the symposium, which brought together TB survivors, healthcare professionals and researchers. Our document offers expert opinion and, where possible, evidence-based guidance to aid clinicians in the diagnosis and management of post-TB conditions and research in this field. It covers all aspects of post-TB, including economic, social and psychological wellbeing, post TB lung disease (PTLD), cardiovascular and pericardial disease, neurological disability, effects in adolescents and children, and future research needs.

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Section: Post-tb Economic Social and Psychological Wellbeingmentioning

confidence: 99%

Post-TB health and wellbeing

Nightingale

Carlin

Meghji

et al. 2023

int j tuberc lung dis

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“…We examined data from the subset of six studies that enrolled some patients who had received retreatment for TB along with first time TB patients, and found that retreatment patients comprised a minority of the study population in five of the six studies [25,28,36,41,44,50]. However, one study [41] exclusively enrolled retreatment TB patients.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Magnitude and factors associated with post-tuberculosis lung disease in low- and middle-income countries: A systematic review and meta-analysis

Maleche‐Obimbo

Odhiambo

Njeri

et al. 2022

PLOS Glob Public Health

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Background Emerging evidence suggests that after completion of treatment for tuberculosis (TB) a significant proportion of patients experience sequelae. However, there is limited synthesized evidence on this from low-income countries, from Sub-Saharan Africa, and in HIV infected individuals. We seek to provide an updated comprehensive systematic review and meta-analysis on the magnitude and factors associated with post-TB lung disease (PTLD) in low- and middle-income countries (LMICs). Methods We searched PubMed, Embase and CINAHL for studies from LMICs with data on post-TB lung health in patients who had previously completed treatment for pulmonary TB. Data on study characteristics, prevalence of PTLD–specifically abnormal lung function (spirometry), persisting respiratory symptoms and radiologic abnormalities were abstracted. Statistical analysis was performed using Microsoft Excel and R version 4.1 software, and random effects meta-analysis conducted to compute pooled prevalence of PTLD, evaluate heterogeneity, and assess factors associated with PTLD. Results We identified 32 eligible studies with 6225 participants. Twenty-one studies were from Africa, 16 included HIV infected participants, spirometry was conducted in 20 studies, symptom assessment in 16 and chest imaging in eight. Pooled prevalence of abnormal lung function was 46.7%, persistent respiratory symptoms 41.0%, and radiologic abnormalities 64.6%. Magnitude of any type of PTLD varied by HIV status (HIV- 66.9%, HIV+ 32.8%, p = 0.0013), across geographic setting (SE Asia 57.5%, Southern America 50.8%, and Africa 38.2%, p = 0.0118), and across urban-rural settings (symptom prevalence: rural 68.8%, urban 39.1%, mixed settings 27.9%, p = 0.0035), but not by income settings, sex or age-group. Conclusions There is high burden of post-TB persistent respiratory symptoms, functional lung impairment and radiologic structural abnormalities in individuals living in LMICs. Burden varies across settings and by HIV status. This evidence may be valuable to advocate for and inform implementation of structured health care specific to the needs of this vulnerable population of individuals.

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“…(3) A tuberculose afeta predominantemente os pulmões, e muitos pacientes, não obstante a cura confirmada bacteriologicamente, terão sequelas da tuberculose, com perda da função pulmonar e sintomas respiratórios crônicos, além de diminuição da capacidade de exercício e da qualidade de vida. (4)(5)(6)(7)(8)(9)(10) A prevalência de sequelas pulmonares da tuberculose (SPTB) varia muito, de 18% a 87%, (11) dependendo da população estudada e dos testes de função pulmonar realizados.…”

Section: Introductionunclassified

Post-tuberculosis lung disease: a comparison of Brazilian, Italian, and Mexican cohorts

Silva

Freitas1²,

Guimarães1

et al. 2022

J Bras Pneumol.

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Objective: To evaluate lung function in a cohort of patients with a history of pulmonary tuberculosis in Brazil, as well as to evaluate the decline in lung function over time and compare it with that observed in similar cohorts in Mexico and Italy. Methods: The three cohorts were compared in terms of age, smoking status, pulmonary function test results, six-minute walk test results, and arterial blood gas results. In the Brazilian cohort, pulmonary function test results, six-minute walk test results, and arterial blood gas results right after the end of tuberculosis treatment were compared with those obtained at the end of the follow-up period. Results: The three cohorts were very different regarding pulmonary function test results. The most common ventilatory patterns in the Brazilian, Italian, and Mexican cohorts were an obstructive pattern, a mixed pattern, and a normal pattern (in 58 patients [50.9%], in 18 patients [41.9%], and in 26 patients [44.1%], respectively). Only 2 multidrug-resistant tuberculosis cases were included in the Brazilian cohort, whereas, in the Mexican cohort, 27 cases were included (45.8%). Mean PaO2 and mean SaO2 were lower in the Mexican cohort than in the Brazilian cohort (p < 0.0001 and p < 0.002 for PaO2 and SaO2, respectively). In the Brazilian cohort, almost all functional parameters deteriorated over time. Conclusions: This study reinforces the importance of early and effective treatment of drug-susceptible tuberculosis patients, because multidrug-resistant tuberculosis increases lung damage. When patients complete their tuberculosis treatment, they should be evaluated as early as possible, and, if post-tuberculosis lung disease is diagnosed, they should be managed and offered pulmonary rehabilitation because there is evidence that it is effective in these patients.

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The burden and determinants of post-TB lung disease

Cited by 35 publications

References 34 publications

Post-TB health and wellbeing

Post-TB health and wellbeing

Magnitude and factors associated with post-tuberculosis lung disease in low- and middle-income countries: A systematic review and meta-analysis

Post-tuberculosis lung disease: a comparison of Brazilian, Italian, and Mexican cohorts

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