Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function
METHODS: This was a cross-sectional survey of adults in Cape Town, South Africa who completed TB treatment 1–5 years previously. Questionnaires, spirometry and 6-minute walking distance (6MWD) were used to assess relationships between outcome measures and associated factors.
RESULTS: Of the 145 participants recruited (mean age: 42 years, range: 18–75; 55 [38%] women), 55 (38%) had airflow obstruction and 84 (58%) had low forced vital capacity (FVC); the mean 6MWD was 463 m (range: 240–723). Respiratory symptoms were common: chronic cough (n = 27, 19%), wheeze (n = 61, 42%) and dyspnoea (modified MRC dyspnoea score 3 or 4: n = 36, 25%). There was poor correlation between FVC or obstruction and 6MWD. Only low body mass index showed consistent association with outcomes on multivariable analyses. Only 19 (13%) participants had a diagnosis of respiratory disease, and 16 (11%) currently received inhalers.
CONCLUSION: There was substantial burden of symptoms and physiological impairment in this “cured” population, but poor correlation between objective outcome measures, highlighting deficits in our understanding of PTLD.
Document Type: Research Article
Affiliations: 1: Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Hospital, Tygerberg, South Africa 2: Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK 3: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa 4: Department of Science and Innovation-National Research Foundation South African Centre for Excellence in Epidemiological Modelling and Analysis (SACEMA), Faculty of Science, Stellenbosch University, Stellenbosch, South Africa 5: Department of Physical Medicine and Rehabilitation, School of Medicine, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia 6: Kibong´oto Infectious Diseases Hospital, Kilimanjaro, Tanzania 7: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa, Department of Science and Innovation-National Research Foundation South African Centre for Excellence in Epidemiological Modelling and Analysis (SACEMA), Faculty of Science, Stellenbosch University, Stellenbosch, South Africa 8: Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, South Africa, Liverpool School of Tropical Medicine, Liverpool, UK 9: Lung Health Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi, Liverpool School of Tropical Medicine, Liverpool, UK 10: Liverpool School of Tropical Medicine, Liverpool, UK
Publication date: April 1, 2021
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