Residual lung damage after completion of treatment for multidrug-resistant tuberculosis
OBJECTIVE: To assess the residual lung damage of patients who completed treatment for multidrug-resistant tuberculosis (MDR-TB).
DESIGN: Chest radiograph and lung function tests were performed at the end of treatment. The radiographs were read by two independent observers who attributed a zonal score of between 0 and 18, depending on the extent of radiographic abnormalities (opacification or cavitation), counted the number of visible cavities and measured the diameter of the largest cavity.
RESULTS: The mean zonal score was 6.5. Cavitation was present in more than half of the patients. Of 33 patients, 31 (94%) had abnormal lung function tests. The median FEV1 was 63% and FVC was 57% of the predicted value. Restrictive and combined restrictive-obstructive lung function patterns were the predominant abnormalities.
CONCLUSIONS: Residual lung damage in MDR-TB patients who completed treatment is common and extensive. This may increase the risk of relapse of tuberculosis and reduce the quality of life and life expectancy of these patients. Additional efforts are warranted to diagnose MDR-TB early to reduce the extent of residual lung damage. Close follow-up of MDR-TB patients completing treatment will have to be ensured to detect relapses.
Document Type: Regular Paper
Affiliations: 1: Division of Infectious Diseases, St Louis University Hospital, St Louis, Missouri, USA; and Department of Internal Medicine, Pietersburg Mankweng Hospital Complex, Polokwane, Limpopo Province, South Africa 2: King's College Hospital, London, United Kingdom
Publication date: 2004-06-01
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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