Quantifying the global number of tuberculosis survivors [TB0084]

·  Increased Health Risks for Tuberculosis Survivors:

  • Higher likelihood of recurrent tuberculosis and increased all-cause mortality, regardless of treatment adequacy.
  • Increased risk of chronic respiratory diseases, with many survivors experiencing abnormal spirometry, chronic symptoms, and impaired lung function (such as low forced vital capacity and reduced forced expiratory volume).
  • Elevated risk of mortality, cardiovascular disease, and hospitalizations due to respiratory issues.
  • Reduction in health-related quality of life, exercise tolerance, and increased social stigma and economic challenges post-treatment. See also: Lin TB Lab

·  Social and Economic Impacts:

·  Population and Disability Burden:

·  Healthcare Needs and Interventions:

  • Tuberculosis survivors have complex health needs that require a multidisciplinary approach, involving tuberculosis programs and non-communicable disease clinics.
  • Recommended interventions include lung function evaluation and treatments (e.g., bronchodilators, antibiotics, steroid therapy) to manage chronic respiratory morbidity.
  • In low-resource settings, interventions like pneumococcal vaccination, pulmonary rehabilitation, and smoking cessation promotion can improve quality of life. See also: https://tbreadingnotes.blogspot.com/2024/07/effects-of-smoking-and-solid-fuel-use.html

·  Impact on Childhood Survivors:

  • Childhood tuberculosis can result in lifelong lung function impairment, emphasizing the importance of early prevention and diagnosis.
  • About 12% of post-tuberculosis life-years lost were due to childhood tuberculosis, highlighting the need for protective measures to enhance lung growth and capacity.

·  Financial Impact and Social Support:

  • Many tuberculosis patients are economically vulnerable, with treatment costs often resulting in catastrophic, long-term financial strain.
  • Social protection programs offering financial, food, or housing support could mitigate these effects and reduce treatment-related costs.

·  Need for Further Research:

  • There is a critical need for large, prospective studies to better understand post-tuberculosis lung damage, its long-term morbidity effects, and to develop targeted treatments.
  • Future trials should assess not only microbiological cure but also the impact of therapies on post-treatment morbidity to improve long-term health outcomes for survivors.
Source:
Dodd, P.J., Yuen, C.M., Jayasooriya, S.M., van der Zalm, M.M. and Seddon, J.A., 2021. Quantifying the global number of tuberculosis survivors: a modelling study. The Lancet Infectious Diseases, 21(7), pp.984-992.

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