Prevalence and Spectrum of Post-Tuberculosis Lung Disease and Its Impact on Health-Related Quality of Life: A Cross-Sectional Study at a Tertiary Care Hospital
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Abstract
Background: Post-tuberculosis lung disease (PTLD) represents a spectrum of persistent structural and functional pulmonary abnormalities following successful completion of anti-TB therapy, encompassing obstructive, restrictive, and mixed ventilatory defects, bronchiectasis, fibrosis, and severely impaired quality of life. India's high TB burden makes PTLD a growing public health concern that remains underaddressed in national follow-up programmes.
Methods: A cross-sectional study enrolled 200 adults who had completed pulmonary TB treatment >6 months prior, attending a tertiary care hospital. Clinical evaluation, pre- and post-bronchodilator spirometry (GLI-2012), HRCT chest, six-minute walk test (6MWT), modified MRC dyspnoea scale, and St George's Respiratory Questionnaire (SGRQ) were performed.
Results: Any PTLD was identified in 68.0% of patients. Spirometric patterns: obstructive 28.0%, restrictive 18.0%, mixed 14.0%; normal spirometry but radiological abnormality 8.0%. Bronchiectasis on HRCT was present in 41.0% and fibrosis in 36.0%. Mean 6MWD was 384±86 m; mean SGRQ total score 38.4±16.2. Independent predictors of moderate-severe airflow obstruction: prior MDR-TB (aOR 2.8), smoking ≥20 pack-years (aOR 3.6), >2 TB episodes (aOR 2.4), and treatment delay >2 months (aOR 1.9).
Conclusion: PTLD affects nearly 70% of TB survivors at this tertiary care hospital, with a substantial burden of bronchiectasis, airflow obstruction, and impaired quality of life. Integration of post-TB pulmonary follow-up — including spirometry, HRCT, and rehabilitative assessment — into the NTEP treatment completion pathway is urgently recommended.
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References
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