Lung function and health-related quality of life among adult patients following pulmonary TB treatment
Josephine Zawedde, Rebecca Abelman, Emmanuel Musisi, Agnes Nyabigambo, Ingvar Sanyu, Sylvia Kaswabuli, Patrick Byanyima, E. J. Lewis, A. Sessolo, R. Lalitha, Noah Kiwanuka, Kristina Crothers, William Worodria, J. Lucian Davis, Laurence Huang
Abstract
<sec><title>OBJECTIVES</title>Pulmonary TB (PTB) increases the risk of chronic lung complications, which are associated with increased morbidity and mortality. We determined the prevalence and predictors of post-TB lung disease and persistent symptoms in a resource-limited setting.</sec><sec><title>METHODS</title>Adults who completed PTB treatment underwent spirometry and completed the St. George’s Respiratory Questionnaire (SGRQ), a questionnaire that assesses quality of life on symptom, activity, and impact. We performed multivariate analyses to calculate the X-adjusted prevalence ratio (PR adj ) of abnormal spirometry and identify associated risk factors.</sec><sec><title>RESULTS</title>Among the 162 participants, 89 (54.9%) were male. The median age was 32 years, and 65 (40.1%) had HIV. Overall, 65 participants (40.1%) had abnormal lung function, with spirometric restriction seen in 29.0%, obstruction in 4.9%, and a mixed pattern in 6.2%. Smoking (PR adj 1.88, 95% CI 1.11–3.16; P = 0.02) and female sex (PR adj 1.81, 95% Cl 1.15–2.84; P = 0.01) were independent risk factors for abnormal lung function. The median SGRQ scores were higher in participants with cavitation ( P < 0.001) or bilateral consolidation on initial chest X-ray ( P = 0.01).</sec><sec><title>CONCLUSIONS</title>Lung function abnormalities, particularly spirometric restriction, are common in patients completing PTB treatment. Female sex and smoking status were associated with lung function abnormalities; therefore, additional studies to understand the underlying mechanistic pathways are warranted.</sec>