Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function

• DOI: 10.5588/ijtld.20.0906
• Publication Date: 2021-03-25T04:30:32Z
• Authors: B. W. Allwood; M. Stolbrink; N. Baines; E. Louw; D. T. Wademan; A. Lupton-Smith; S. Nel; D. Maree; S. Mpagama; M. Osman; F. M. Marx; G. Hoddinott; M. Lesosky; J. Rylance; K. Mortimer;; on behalf of the...
• Keywords: 0301 basic medicine; Epidemiology; Vital Capacity; FOS: Health sciences; Pediatrics; Pulmonary Disease, Chronic Obstructive; South Africa; Forced Expiratory Volume; Chronic cough; Pathology; Internal medicine; Lung; Management and Epidemiology of Pneumonia; Body mass index; Respiratory disease; pulmonary disease; 0303 health sciences; Incidence (geometry); Physics; 3. Good health; Wheeze; Infectious Diseases; Environmental health; Respiratory; Medicine; Female; wf_200; wf_600; Adult; Pulmonary and Respiratory Medicine; Vital capacity; Population; wa_395; Respiratory system; 03 medical and health sciences; Health Sciences; Humans; Tuberculosis; Standardisation and Management of COPD; Cross-sectional study; Diffusing capacity; QR355; lung function; Optics; Original Articles; Asthma; Lung function; Cross-Sectional Studies; Spirometry; wf_100; RB; Physical therapy

BACKGROUND: Persistent respiratory symptoms and lung function deficits are common after patients with TB. We aimed to define the burden of post-TB lung disease (PTLD) and assess associations between symptoms and impairment in two high TB incidence communities.METHODS: This was a cross-sectional survey of adults in Cape Town, South Africa who completed TB treatment 1–5 years previously. Questionnaires, spirometry and 6-minute walking distance (6MWD) were used to assess relationships between outcome measures and associated factors.RESULTS: Of the 145 participants recruited (mean age: 42 years, range: 18–75; 55 [38%] women), 55 (38%) had airflow obstruction and 84 (58%) had low forced vital capacity (FVC); the mean 6MWD was 463 m (range: 240–723). Respiratory symptoms were common: chronic cough (n = 27, 19%), wheeze (n = 61, 42%) and dyspnoea (modified MRC dyspnoea score 3 or 4: n = 36, 25%). There was poor correlation between FVC or obstruction and 6MWD. Only low body mass index showed consistent association with outcomes on multivariable analyses. Only 19 (13%) participants had a diagnosis of respiratory disease, and 16 (11%) currently received inhalers.CONCLUSION: There was substantial burden of symptoms and physiological impairment in this “cured” population, but poor correlation between objective outcome measures, highlighting deficits in our understanding of PTLD.