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Open Access The burden and determinants of post-TB lung disease

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BACKGROUND: Post-TB lung disease (PTLD) is an important but under-recognised chronic respiratory disease in high TB burden settings such as Tanzania.

METHODS: This was a cross-sectional survey of adults within 2 years of completion of TB treatment in Kilimanjaro, Tanzania. Data were collected using questionnaires (symptoms and exposures), spirometry and chest radiographs to assess outcome measures, which were correlated with daily life exposures, including environment and diet.

RESULTS: Of the 219 participants enrolled (mean age: 45 years ± 10; 193 88% males), 98 (45%) reported chronic respiratory symptoms; 46 (22%) had received treatment for TB two or more times; and HIV prevalence was 35 (16%). Spirometric abnormalities were observed in 146 (67%). Chest X-ray abnormalities occurred in 177 (86%). A diagnosis of PTLD was made in 200 (91%), and half had clinically relevant PTLD. The prevalence of mMRC ≥Grade 3 chronic bronchitis and dyspnoea was respectively 11% and 26%. Older age, multiple episodes of TB and poverty indicators were linked with clinically relevant PTLD.

CONCLUSIONS: We found a substantial burden of PTLD in adults who had recently completed TB treatment in Tanzania. There is a pressing need to identify effective approaches for both the prevention and management of this disease.

Keywords: mixed-pattern; obstruction; post-tuberculosis; radiographs; spirometry

Document Type: Research Article

Affiliations: 1: Kibong´oto Infectious Diseases Hospital, Kilimanjaro, Tanzania, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania 2: Kibong´oto Infectious Diseases Hospital, Kilimanjaro, Tanzania 3: Education for Health Africa, Mount Edgecombe, Durban, South Africa 4: Kibong´oto Infectious Diseases Hospital, Kilimanjaro, Tanzania, Nelson Mandela African Institution of Science & Technology, Arusha, Tanzania 5: Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Hospital, Tygerberg, South Africa 6: Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa 7: Lung Health Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK 8: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK

Publication date: October 1, 2021

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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