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

B. W. Allwood; Marie Stolbrink; N. Baines; E. Louw; D. T. Wademan; A. Lupton-Smith; S. Nel; D. Maree; S. Mpagama; M. Osman; F. M. Marx; G. Hoddinott; Maia Lesosky; Jamie Rylance; Kevin Mortimer

doi:10.5588/ijtld.20.0906

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

B. W. Allwood, Marie Stolbrink, N. Baines, E. Louw, D. T. Wademan, A. Lupton-Smith, S. Nel, D. Maree, S. Mpagama, M. Osman, F. M. Marx, G. Hoddinott, Maia Lesosky, Jamie Rylance, Kevin Mortimer

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

42 Citations (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	262-270
Number of pages	9
Journal	International Journal of Tuberculosis and Lung Disease
Volume	25
Issue number	4
Early online date	25 Mar 2021
DOIs	https://doi.org/10.5588/ijtld.20.0906
Publication status	Published - 1 Apr 2021

Keywords

K E Y W O R D S: post-TB
Obstruction
Physiology
Restriction
Spirometry

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Poor Lung TBFinal published version, 299 KBLicence: CC BY

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Allwood, B. W., Stolbrink, M., Baines, N., Louw, E., Wademan, D. T., Lupton-Smith, A., Nel, S., Maree, D., Mpagama, S., Osman, M., Marx, F. M., Hoddinott, G., Lesosky, M., Rylance, J., & Mortimer, K. (2021). Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function. International Journal of Tuberculosis and Lung Disease, 25(4), 262-270. https://doi.org/10.5588/ijtld.20.0906

@article{31b90d7e54804d5cbfece9c354e6ab39,

title = "Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function",

abstract = "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.",

keywords = "K E Y W O R D S: post-TB, Obstruction, Physiology, Restriction, Spirometry",

author = "Allwood, \{B. W.\} and Marie Stolbrink and N. Baines and E. Louw and Wademan, \{D. T.\} and A. Lupton-Smith and S. Nel and D. Maree and S. Mpagama and M. Osman and Marx, \{F. M.\} and G. Hoddinott and Maia Lesosky and Jamie Rylance and Kevin Mortimer",

year = "2021",

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day = "1",

doi = "10.5588/ijtld.20.0906",

language = "English",

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Allwood, BW, Stolbrink, M, Baines, N, Louw, E, Wademan, DT, Lupton-Smith, A, Nel, S, Maree, D, Mpagama, S, Osman, M, Marx, FM, Hoddinott, G, Lesosky, M, Rylance, J & Mortimer, K 2021, 'Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function', International Journal of Tuberculosis and Lung Disease, vol. 25, no. 4, pp. 262-270. https://doi.org/10.5588/ijtld.20.0906

TY - JOUR

T1 - Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function

AU - Allwood, B. W.

AU - Stolbrink, Marie

AU - Baines, N.

AU - Louw, E.

AU - Wademan, D. T.

AU - Lupton-Smith, A.

AU - Nel, S.

AU - Maree, D.

AU - Mpagama, S.

AU - Osman, M.

AU - Marx, F. M.

AU - Hoddinott, G.

AU - Lesosky, Maia

AU - Rylance, Jamie

AU - Mortimer, Kevin

PY - 2021/4/1

Y1 - 2021/4/1

N2 - 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.

AB - 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.

KW - K E Y W O R D S: post-TB

KW - Obstruction

KW - Physiology

KW - Restriction

KW - Spirometry

U2 - 10.5588/ijtld.20.0906

DO - 10.5588/ijtld.20.0906

M3 - Article

SN - 1027-3719

VL - 25

SP - 262

EP - 270

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

IS - 4

ER -

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

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Keywords

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