Residual respiratory disability after successful treatment of pulmonary TB

Taylor, J., Bastos, M.L., Lachapelle-Chisholm, S., Mayo, N.E., Johnston, J. and Menzies, D., 2023. Residual respiratory disability after successful treatment of pulmonary tuberculosis: a systematic review and meta-analysis. EClinicalMedicine, 59. [TB0041]

·       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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