WHO, 2023. Global Tuberculosis Report 2023. Available at: https://www.who.int/publications/i/item/9789240083851. Accessed February 13, 2024.
Fan H, et al., 2021. Pulmonary tuberculosis as a risk factor for chronic obstructive pulmonary disease: A systematic review and meta-analysis. Ann Transl Med 9: 390.
IHME, 2020. Global Burden of Disease (GBD). Available at: https://www.healthdata.org/research-analysis/gbd. Accessed February 13, 2024.
Magee MJ, Salindri AD, Gujral UP, Auld SC, Bao J, Haw JS, Lin HH, Kornfeld H, 2018. Convergence of non-communicable diseases and tuberculosis: A two-way street? Int J Tuberc Lung Dis 22: 1258–1268.
Byrne AL, Marais BJ, Mitnick CD, Lecca L, Marks GB, 2015. Tuberculosis and chronic respiratory disease: A systematic review. Int J Infect Dis 32: 138–146.
Ehrlich RI, White N, Norman R, Laubscher R, Steyn K, Lombard C, Bradshaw D, 2004. Predictors of chronic bronchitis in South African adults. Int J Tuberc Lung Dis 8: 369–376.
Oni T, Unwin N, 2015. Why the communicable/non-communicable disease dichotomy is problematic for public health control strategies: Implications of multimorbidity for health systems in an era of health transition. Int Health 7: 390–399.
Ogbo FA, Ogeleka P, Okoro A, Olusanya BO, Olusanya J, Ifegwu IK, Awosemo AO, Eastwood J, Page A, 2018. Tuberculosis disease burden and attributable risk factors in Nigeria, 1990–2016. Trop Med Health 46: 34.
Hsu D, Irfan M, Jabeen K, Iqbal N, Hasan R, Migliori GB, Zumla A, Visca D, Centis R, Tiberi S, 2020. Post tuberculosis treatment infectious complications. Int J Infect Dis 92S: S41–S45.
Ranzani OT, Rodrigues LC, Bombarda S, Minto CM, Waldman EA, Carvalho CRR, 2020. Long-term survival and cause-specific mortality of patients newly diagnosed with tuberculosis in São Paulo state, Brazil, 2010-15: A population-based, longitudinal study. Lancet Infect Dis 20: 123–132.
Ravimohan S, Kornfeld H, Weissman D, Bisson GP, 2018. Tuberculosis and lung damage: From epidemiology to pathophysiology. Eur Respir Rev 27: 170077.
Meghji J, et al., 2020. Patient outcomes associated with post-tuberculosis lung damage in Malawi: A prospective cohort study. Thorax 75: 269–278.
Allwood BW, Byrne A, Meghji J, Rachow A, van der Zalm MM, Schoch OD, 2021. Post-tuberculosis lung disease: Clinical review of an under-recognised global challenge. Respiration 100: 751–763.
DiFazio RM, Mattila JT, Klein EC, Cirrincione LR, Howard M, Wong EA, Flynn JL, 2016. Active transforming growth factor-β is associated with phenotypic changes in granulomas after drug treatment in pulmonary tuberculosis. Fibrogenesis Tissue Repair 9: 6.
Riou C, et al., 2012. Effect of standard tuberculosis treatment on plasma cytokine levels in patients with active pulmonary tuberculosis. PLoS One 7: e36886.
Bansal A, Yanamaladoddi VR, Sarvepalli SS, Vemula SL, Aramadaka S, Mannam R, Sankara Narayanan R, 2023. Surviving pulmonary tuberculosis: Navigating the long term respiratory effects. Cureus 15: e38811.
Plit ML, Anderson R, Van Rensburg CE, Page-Shipp L, Blott JA, Fresen JL, Feldman C, 1998. Influence of antimicrobial chemotherapy on spirometric parameters and pro-inflammatory indices in severe pulmonary tuberculosis. Eur Respir J 12: 351–356.
Bashir H, Musa BM, Babashani MB, Imam H, Musa A, Okpapi JU, 2022. Ventilatory function phenotypes in patients with pulmonary tuberculosis. J Niger Infect Dis Soc 1: 76–87.
National Tuberculosis and Leprosy Control Programme, 2020. Tuberculosis Epidemiological Review in Nigeria. Available at: https://ntblcp.org.ng/content/uploads/2023/06/draft-Nigeria-Epi-review-March-02.pdf. Accessed February 13, 2024.
National Tuberculosis and Leprosy Control Programme, 2021. The 2021 National Guidelines for the Management of TB/HIV. Available at: https://ntblcp.org.ng/resources/the-2021-national-guidelines-for-the-management-of-tb-hiv/. Accessed June 22, 2024.
Ivanova O, Hoffmann VS, Lange C, Hoelscher M, Rachow A, 2023. Post-tuberculosis lung impairment: Systematic review and meta-analysis of spirometry data from 14 621 people. Eur Respir Rev 32: 220221.
Lee JH, Chang JH, 2003. Lung function in patients with chronic airflow obstruction due to tuberculous destroyed lung. Respir Med 97: 1237–1242.
Sahebi L, Rahimi B, Shariat M, Mousavy SH, 2022. Evaluation of the Global Lung Function Initiative 2012 reference values for spirometry in an Iranian population. Sci Rep 12: 12784.
Quanjer PH, et al., ERS Global Lung Function Initiative, 2012. Multi-ethnic reference values for spirometry for the 3-95-yr age range: The global lung function 2012 equations. Eur Respir J 40: 1324–1343.
Graham BL, et al., 2019. Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med 200: e70–e88.
Singhal R, Myneedu VP, 2015. Microscopy as a diagnostic tool in pulmonary tuberculosis. Int J Mycobacteriol 4: 1–6.
Lee H-S, et al., 2019. Xpert MTB/RIF assay as a substitute for smear microscopy in an intermediate-burden setting. Am J Respir Crit Care Med 199: 784–794.
Akanbi MO, et al., 2017. Evaluation of gene xpert for routine diagnosis of HIV-associated tuberculosis in Nigeria: A prospective cohort study. BMC Pulm Med 17: 87.
Ozoh OB, Ojo OO, Dania MG, Dede SK, Adegboyega OA, Irurhe NK, Olowoyeye M, Adeyeye OO, 2021. Impact of post-tuberculosis lung disease on health-related quality of life in patients from two tertiary hospitals in Lagos, Nigeria. Afr J Thorac Crit Care Med 27: 47–53.
Ojuawo OB, Fawibe AE, Desalu OO, Ojuawo AB, Aladesanmi AO, Opeyemi CM, Adio MO, Salami AK, 2020. Spirometric abnormalities following treatment for pulmonary tuberculosis in Ilorin, Nigeria. Niger Postgrad Med J 27: 163–170.
Stek C, Allwood B, Walker NF, Wilkinson RJ, Lynen L, Meintjes G, 2018. The immune mechanisms of lung parenchymal damage in tuberculosis and the role of host-directed therapy. Front Microbiol 9: 2603.
Herrera MT, Guzmán-Beltrán S, Bobadilla K, Santos-Mendoza T, Flores-Valdez MA, Gutiérrez-González LH, González Y, 2022. Human pulmonary tuberculosis: Understanding the immune response in the bronchoalveolar system. Biomolecules 12: 1148.
Allwood BW, Maasdorp E, Kim GJ, Cooper CB, Goldin J, van Zyl-Smit RN, Bateman ED, Dawson R, 2020. Transition from restrictive to obstructive lung function impairment during treatment and follow-up of active tuberculosis. Int J Chron Obstruct Pulmon Dis 15: 1039–1047.
Sharma N, Ahmed S, 2022. Structural and functional pulmonary impairment in treated cases of pulmonary tuberculosis: A cross-sectional study. Med J Armed Forces India 78: 151–156.
Ko Y, Lee YM, Lee HY, Lee YS, Song JW, Hong GY, Kim MY, Lee HK, Choi SJ, Shim EJ, 2015. Changes in lung function according to disease extent before and after pulmonary tuberculosis. Int J Tuberc Lung Dis 19: 589–595.
Kayongo A, Nyiro B, Siddharthan T, Kirenga B, Checkley W, Lutaakome Joloba M, Ellner J, Salgame P, 2023. Mechanisms of lung damage in tuberculosis: Implications for chronic obstructive pulmonary disease. Front Cell Infect Microbiol 13: 1146571.
Amaral AFS, et al.; BOLD Collaborative Research Group, 2015. Tuberculosis associates with both airflow obstruction and low lung function: BOLD results. Eur Respir J 46: 1104–1112.
Menezes AMB, et al.; Latin American Project for the Investigation of Obstructive Lung Disease (PLATINO) Team, 2007. Tuberculosis and airflow obstruction: Evidence from the PLATINO study in Latin America. Eur Respir J 30: 1180–1185.
Abdelaleem NA, Ahmed MK, Mohamed MN, Bayoumi HA, 2022. Lung health after tuberculosis: Clinical and functional assessment in post-pulmonary tuberculosis Egyptian patients. Egypt J Bronchol 16: 23.
Atif M, Sulaiman SAS, Shafie AA, Asif M, Sarfraz MK, Low HC, Babar Z-U-D, 2014. Impact of tuberculosis treatment on health-related quality of life of pulmonary tuberculosis patients: A follow-up study. Health Qual Life Outcomes 12: 19.
Lippincott CK, Miller MB, Popowitch EB, Hanrahan CF, Van Rie A, 2014. Xpert MTB/RIF assay shortens airborne isolation for hospitalized patients with presumptive tuberculosis in the United States. Clin Infect Dis 59: 186–192.
Past two years | Past Year | Past 30 Days | |
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Abstract Views | 537 | 537 | 192 |
Full Text Views | 12 | 12 | 5 |
PDF Downloads | 17 | 17 | 6 |
Tuberculosis (TB) is a leading cause of morbidity and mortality and an important contributory factor to chronic lung disease. TB-associated permanent lung damage manifests with varying levels of respiratory disability long after TB has been successfully treated, which is a condition known as post-TB lung disease (PTLD). This study assessed whether lung function impairment associated with PTLD occurs early during TB treatment. Using a cross-sectional design, we enrolled newly diagnosed adult TB patients aged ≥18 years who had received anti-TB medication for ≥2 months from a large treatment center in northern Nigeria. We used spirometry and the Global Lung Initiative 2012 reference equations for African Americans to assess and characterize lung function for enrolled participants (N = 94). The median age (range) of participants was 34 (18–72) years. Approximately 5.3% (n = 5) of participants exhibited features of abnormal lung function, 4.2% (n = 4) showed features of obstructive lung abnormality, and 1.1% (n = 1) showed restrictive lung abnormality. Compared with historical patients recruited ≥6 months after TB treatment in the same center, our participants had significantly lower forced expiratory volume in one second and forced vital capacity values. Our findings suggest an opportunity for early intervention for primary and secondary prevention of PTLD to reduce the impact of severe respiratory impairment.
Financial support: This study was funded by a Tertiary Education Trust Fund (TETFund) National Research Foundation grant to Bayero University Kano (PI: Dr. Baba Musa) and by the
Disclosure: Ethical approval for the study was provided by the Research Ethics Committee of AKTH, Kano, Nigeria (NHREC/21/08/2008/AKTH/EC/1876).
Current contact information: Baba M. Musa, African Center of Excellence for Population Health and Policy, Bayero University, Kano, Kano, Nigeria, and Department of Medicine, Bayero University, Kano, Kano, Nigeria, E-mails: babamaiyaki2000@yahoo.co.uk or babamaiyaki200016@gmail.com. Faisal S. Dankishiya, African Center of Excellence for Population Health and Policy, Bayero University, Kano, Kano, Nigeria E-mail: fdankishiya@yahoo.com. Musa Babashani and Hadiza Saidu, Department of Medicine, Bayero University, Kano, Kano, Nigeria, E-mails: babashanim@yahoo.com and hsaidu2006@yahoo.com. Aisha Musa, Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria, E-mail: addaulataisha@gmail.com. Mohammed K. Saleh, Department of Radiology, Bayero University, Kano, Kano, Nigeria, E-mail: mk_saleh@yahoo.com. Hafsat U. Ibrahim, Department of Paediatrics, Bayero University, Kano, Kano, Nigeria, E-mail: hsaidu2006@yahoo.com. Aishatu L. Adamu, Department of Community Medicine, Bayero University, Kano and Aminu Kano Teaching Hospital, Kano, Nigeria, E-mail: aladamu.cmed@buk.edu.ng. Muktar H. Aliyu, Vanderbilt Institute of Global Health, Vanderbilt University, Nashville, TN, E-mail: muktar.aliyu@vumc.org.
WHO, 2023. Global Tuberculosis Report 2023. Available at: https://www.who.int/publications/i/item/9789240083851. Accessed February 13, 2024.
Fan H, et al., 2021. Pulmonary tuberculosis as a risk factor for chronic obstructive pulmonary disease: A systematic review and meta-analysis. Ann Transl Med 9: 390.
IHME, 2020. Global Burden of Disease (GBD). Available at: https://www.healthdata.org/research-analysis/gbd. Accessed February 13, 2024.
Magee MJ, Salindri AD, Gujral UP, Auld SC, Bao J, Haw JS, Lin HH, Kornfeld H, 2018. Convergence of non-communicable diseases and tuberculosis: A two-way street? Int J Tuberc Lung Dis 22: 1258–1268.
Byrne AL, Marais BJ, Mitnick CD, Lecca L, Marks GB, 2015. Tuberculosis and chronic respiratory disease: A systematic review. Int J Infect Dis 32: 138–146.
Ehrlich RI, White N, Norman R, Laubscher R, Steyn K, Lombard C, Bradshaw D, 2004. Predictors of chronic bronchitis in South African adults. Int J Tuberc Lung Dis 8: 369–376.
Oni T, Unwin N, 2015. Why the communicable/non-communicable disease dichotomy is problematic for public health control strategies: Implications of multimorbidity for health systems in an era of health transition. Int Health 7: 390–399.
Ogbo FA, Ogeleka P, Okoro A, Olusanya BO, Olusanya J, Ifegwu IK, Awosemo AO, Eastwood J, Page A, 2018. Tuberculosis disease burden and attributable risk factors in Nigeria, 1990–2016. Trop Med Health 46: 34.
Hsu D, Irfan M, Jabeen K, Iqbal N, Hasan R, Migliori GB, Zumla A, Visca D, Centis R, Tiberi S, 2020. Post tuberculosis treatment infectious complications. Int J Infect Dis 92S: S41–S45.
Ranzani OT, Rodrigues LC, Bombarda S, Minto CM, Waldman EA, Carvalho CRR, 2020. Long-term survival and cause-specific mortality of patients newly diagnosed with tuberculosis in São Paulo state, Brazil, 2010-15: A population-based, longitudinal study. Lancet Infect Dis 20: 123–132.
Ravimohan S, Kornfeld H, Weissman D, Bisson GP, 2018. Tuberculosis and lung damage: From epidemiology to pathophysiology. Eur Respir Rev 27: 170077.
Meghji J, et al., 2020. Patient outcomes associated with post-tuberculosis lung damage in Malawi: A prospective cohort study. Thorax 75: 269–278.
Allwood BW, Byrne A, Meghji J, Rachow A, van der Zalm MM, Schoch OD, 2021. Post-tuberculosis lung disease: Clinical review of an under-recognised global challenge. Respiration 100: 751–763.
DiFazio RM, Mattila JT, Klein EC, Cirrincione LR, Howard M, Wong EA, Flynn JL, 2016. Active transforming growth factor-β is associated with phenotypic changes in granulomas after drug treatment in pulmonary tuberculosis. Fibrogenesis Tissue Repair 9: 6.
Riou C, et al., 2012. Effect of standard tuberculosis treatment on plasma cytokine levels in patients with active pulmonary tuberculosis. PLoS One 7: e36886.
Bansal A, Yanamaladoddi VR, Sarvepalli SS, Vemula SL, Aramadaka S, Mannam R, Sankara Narayanan R, 2023. Surviving pulmonary tuberculosis: Navigating the long term respiratory effects. Cureus 15: e38811.
Plit ML, Anderson R, Van Rensburg CE, Page-Shipp L, Blott JA, Fresen JL, Feldman C, 1998. Influence of antimicrobial chemotherapy on spirometric parameters and pro-inflammatory indices in severe pulmonary tuberculosis. Eur Respir J 12: 351–356.
Bashir H, Musa BM, Babashani MB, Imam H, Musa A, Okpapi JU, 2022. Ventilatory function phenotypes in patients with pulmonary tuberculosis. J Niger Infect Dis Soc 1: 76–87.
National Tuberculosis and Leprosy Control Programme, 2020. Tuberculosis Epidemiological Review in Nigeria. Available at: https://ntblcp.org.ng/content/uploads/2023/06/draft-Nigeria-Epi-review-March-02.pdf. Accessed February 13, 2024.
National Tuberculosis and Leprosy Control Programme, 2021. The 2021 National Guidelines for the Management of TB/HIV. Available at: https://ntblcp.org.ng/resources/the-2021-national-guidelines-for-the-management-of-tb-hiv/. Accessed June 22, 2024.
Ivanova O, Hoffmann VS, Lange C, Hoelscher M, Rachow A, 2023. Post-tuberculosis lung impairment: Systematic review and meta-analysis of spirometry data from 14 621 people. Eur Respir Rev 32: 220221.
Lee JH, Chang JH, 2003. Lung function in patients with chronic airflow obstruction due to tuberculous destroyed lung. Respir Med 97: 1237–1242.
Sahebi L, Rahimi B, Shariat M, Mousavy SH, 2022. Evaluation of the Global Lung Function Initiative 2012 reference values for spirometry in an Iranian population. Sci Rep 12: 12784.
Quanjer PH, et al., ERS Global Lung Function Initiative, 2012. Multi-ethnic reference values for spirometry for the 3-95-yr age range: The global lung function 2012 equations. Eur Respir J 40: 1324–1343.
Graham BL, et al., 2019. Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med 200: e70–e88.
Singhal R, Myneedu VP, 2015. Microscopy as a diagnostic tool in pulmonary tuberculosis. Int J Mycobacteriol 4: 1–6.
Lee H-S, et al., 2019. Xpert MTB/RIF assay as a substitute for smear microscopy in an intermediate-burden setting. Am J Respir Crit Care Med 199: 784–794.
Akanbi MO, et al., 2017. Evaluation of gene xpert for routine diagnosis of HIV-associated tuberculosis in Nigeria: A prospective cohort study. BMC Pulm Med 17: 87.
Ozoh OB, Ojo OO, Dania MG, Dede SK, Adegboyega OA, Irurhe NK, Olowoyeye M, Adeyeye OO, 2021. Impact of post-tuberculosis lung disease on health-related quality of life in patients from two tertiary hospitals in Lagos, Nigeria. Afr J Thorac Crit Care Med 27: 47–53.
Ojuawo OB, Fawibe AE, Desalu OO, Ojuawo AB, Aladesanmi AO, Opeyemi CM, Adio MO, Salami AK, 2020. Spirometric abnormalities following treatment for pulmonary tuberculosis in Ilorin, Nigeria. Niger Postgrad Med J 27: 163–170.
Stek C, Allwood B, Walker NF, Wilkinson RJ, Lynen L, Meintjes G, 2018. The immune mechanisms of lung parenchymal damage in tuberculosis and the role of host-directed therapy. Front Microbiol 9: 2603.
Herrera MT, Guzmán-Beltrán S, Bobadilla K, Santos-Mendoza T, Flores-Valdez MA, Gutiérrez-González LH, González Y, 2022. Human pulmonary tuberculosis: Understanding the immune response in the bronchoalveolar system. Biomolecules 12: 1148.
Allwood BW, Maasdorp E, Kim GJ, Cooper CB, Goldin J, van Zyl-Smit RN, Bateman ED, Dawson R, 2020. Transition from restrictive to obstructive lung function impairment during treatment and follow-up of active tuberculosis. Int J Chron Obstruct Pulmon Dis 15: 1039–1047.
Sharma N, Ahmed S, 2022. Structural and functional pulmonary impairment in treated cases of pulmonary tuberculosis: A cross-sectional study. Med J Armed Forces India 78: 151–156.
Ko Y, Lee YM, Lee HY, Lee YS, Song JW, Hong GY, Kim MY, Lee HK, Choi SJ, Shim EJ, 2015. Changes in lung function according to disease extent before and after pulmonary tuberculosis. Int J Tuberc Lung Dis 19: 589–595.
Kayongo A, Nyiro B, Siddharthan T, Kirenga B, Checkley W, Lutaakome Joloba M, Ellner J, Salgame P, 2023. Mechanisms of lung damage in tuberculosis: Implications for chronic obstructive pulmonary disease. Front Cell Infect Microbiol 13: 1146571.
Amaral AFS, et al.; BOLD Collaborative Research Group, 2015. Tuberculosis associates with both airflow obstruction and low lung function: BOLD results. Eur Respir J 46: 1104–1112.
Menezes AMB, et al.; Latin American Project for the Investigation of Obstructive Lung Disease (PLATINO) Team, 2007. Tuberculosis and airflow obstruction: Evidence from the PLATINO study in Latin America. Eur Respir J 30: 1180–1185.
Abdelaleem NA, Ahmed MK, Mohamed MN, Bayoumi HA, 2022. Lung health after tuberculosis: Clinical and functional assessment in post-pulmonary tuberculosis Egyptian patients. Egypt J Bronchol 16: 23.
Atif M, Sulaiman SAS, Shafie AA, Asif M, Sarfraz MK, Low HC, Babar Z-U-D, 2014. Impact of tuberculosis treatment on health-related quality of life of pulmonary tuberculosis patients: A follow-up study. Health Qual Life Outcomes 12: 19.
Lippincott CK, Miller MB, Popowitch EB, Hanrahan CF, Van Rie A, 2014. Xpert MTB/RIF assay shortens airborne isolation for hospitalized patients with presumptive tuberculosis in the United States. Clin Infect Dis 59: 186–192.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 537 | 537 | 192 |
Full Text Views | 12 | 12 | 5 |
PDF Downloads | 17 | 17 | 6 |