Residual respiratory disability after successful treatment of pulmonary TB
·
There
are an estimated 155 million tuberculosis (TB) survivors worldwide, equating to
1 in every 50 people alive in 2020.
·
Rifampin
was approved by the FDA in 1971, and pyrazinamide (PZA) was widely used
starting in 1980.
·
Even
after successful treatment for pulmonary tuberculosis (PTB), many individuals
experience chronic respiratory issues, including abnormal lung function,
bronchiectasis, and an increased risk of lung cancer.
·
More
than half of all individuals who completed PTB treatment showed abnormal
spirometry results.
·
Post-PTB
participants showed significantly lower scores on exercise capacity (6MWT) and
physical disability due to breathlessness (MRC dyspnea scale) compared to
controls.
·
Specifically,
24.7% had activity-limiting dyspnea (MRC score >2), and patients achieved
only 78.9% of the predicted distance on the 6-minute walk test.
·
There
is a fourfold higher risk of developing lung cancer in post-PTB participants
compared to controls.
·
Persistent
cavitation, fibrosis, bronchiectasis, and aspergilloma are frequent
complications following PTB.
·
PTB
is a major cause of worldwide disability, highlighting the importance of
prevention and the potential benefits of TB preventive therapy (TPT) beyond
mortality.
·
To
better estimate the health burden post-PTB treatment, future studies should
focus on translating measures of disability into quality-adjusted life years.
·
Research
on the determinants of disability could help develop strategies to limit or
prevent disability and identify optimal management approaches.
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