The burden and determinants of post-TB lung disease
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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