M Muñoz-Torrico1, S Cid-Juárez2, L Gochicoa-Rangel2, L Torre-Bouscolet3, M A Salazar-Lezama4, H Villarreal-Velarde1, R Pérez-Padilla5, D Visca6, R Centis7, L D'Ambrosio8, A Spanevello6, L Saderi9, G Sotgiu9, G B Migliori10. 1. Tuberculosis Clinic, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City. 2. Physiology Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City. 3. Department of Pulmonology, Hospital Médica Sur, Mexico City, Mexico. 4. Dirección médica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico. 5. Clínica para dejar de fumar y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico. 6. Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici (ICS) Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como. 7. Servizio di Epidemiologia, Clinica delle Malattie Respiratorie, ICS Maugeri, IRCCS, Tradate, Italy. 8. Public Health Consulting Group, Lugano, Switzerland. 9. Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. 10. Servizio di Epidemiologia, Clinica delle Malattie Respiratorie, ICS Maugeri, IRCCS, Tradate, Italy, Blizard Institute, Queen Mary University of London, London, UK.
Abstract
BACKGROUND: Evidence on the impact of tuberculosis (TB) treatment on lung function is scarce. The aim of this study was to evaluate post-treatment sequelae in drug-susceptible and drug-resistant-TB (DR-TB) cases in Mexico and Italy. METHODS: At the end of TB treatment the patients underwent complete clinical assessment, functional evaluation of respiratory mechanics, gas exchange and a 6-minute walking test. Treatment regimens (and definitions) recommended by the World Health Organization were used throughout. RESULTS: Of 61 patients, 65.6% had functional impairment, with obstruction in 24/61 patients (39.4%), and 78% with no bronchodilator response. These effects were more prevalent among DR-TB cases (forced expiratory volume in 1 s/forced vital capacity [FEV1/FVC] < lower limit of normality, 14/24 vs. 10/34; P = 0.075). DR-TB patients showed moderately severe (FEV1 < 60%) and severe obstruction (FEV1 < 50%) (P = 0.008). Pre- and post-bronchodilator FEV1 and FEV1/FVC (% of predicted) were significantly lower among DR-TB cases. Plethysmography abnormalities (restriction, hyperinflation and/or air trapping) were more frequent among DR-TB cases (P = 0.001), along with abnormal carbon monoxide diffusing capacity (DLCO) (P = 0.003). CONCLUSION: The majority of TB patients suffer the consequences of post-treatment sequelae (of differing levels), which compromise quality of life, exercise tolerance and long-term prognosis. It is therefore important that lung function is comprehensively evaluated post-treatment to identify patient needs for future medication and pulmonary rehabilitation.
BACKGROUND: Evidence on the impact of tuberculosis (TB) treatment on lung function is scarce. The aim of this study was to evaluate post-treatment sequelae in drug-susceptible and drug-resistant-TB (DR-TB) cases in Mexico and Italy. METHODS: At the end of TB treatment the patients underwent complete clinical assessment, functional evaluation of respiratory mechanics, gas exchange and a 6-minute walking test. Treatment regimens (and definitions) recommended by the World Health Organization were used throughout. RESULTS: Of 61 patients, 65.6% had functional impairment, with obstruction in 24/61 patients (39.4%), and 78% with no bronchodilator response. These effects were more prevalent among DR-TB cases (forced expiratory volume in 1 s/forced vital capacity [FEV1/FVC] < lower limit of normality, 14/24 vs. 10/34; P = 0.075). DR-TB patients showed moderately severe (FEV1 < 60%) and severe obstruction (FEV1 < 50%) (P = 0.008). Pre- and post-bronchodilator FEV1 and FEV1/FVC (% of predicted) were significantly lower among DR-TB cases. Plethysmography abnormalities (restriction, hyperinflation and/or air trapping) were more frequent among DR-TB cases (P = 0.001), along with abnormal carbon monoxide diffusing capacity (DLCO) (P = 0.003). CONCLUSION: The majority of TB patients suffer the consequences of post-treatment sequelae (of differing levels), which compromise quality of life, exercise tolerance and long-term prognosis. It is therefore important that lung function is comprehensively evaluated post-treatment to identify patient needs for future medication and pulmonary rehabilitation.
Authors: S G Mpagama; K S Msaji; O Kaswaga; L J Zurba; P M Mbelele; B W Allwood; B-S Ngungwa; R M Kisonga; M Lesosky; J Rylance; K Mortimer Journal: Int J Tuberc Lung Dis Date: 2021-10-01 Impact factor: 2.373
Authors: G B Migliori; F M Marx; N Ambrosino; E Zampogna; H S Schaaf; M M van der Zalm; B Allwood; A L Byrne; K Mortimer; R S Wallis; G J Fox; C C Leung; J M Chakaya; B Seaworth; A Rachow; B J Marais; J Furin; O W Akkerman; F Al Yaquobi; A F S Amaral; S Borisov; J A Caminero; A C C Carvalho; D Chesov; L R Codecasa; R C Teixeira; M P Dalcolmo; S Datta; A-T Dinh-Xuan; R Duarte; C A Evans; J-M García-García; G Günther; G Hoddinott; S Huddart; O Ivanova; R Laniado-Laborín; S Manga; K Manika; A Mariandyshev; F C Q Mello; S G Mpagama; M Muñoz-Torrico; P Nahid; C W M Ong; D J Palmero; A Piubello; E Pontali; D R Silva; R Singla; A Spanevello; S Tiberi; Z F Udwadia; M Vitacca; R Centis; L D Ambrosio; G Sotgiu; C Lange; D Visca Journal: Int J Tuberc Lung Dis Date: 2021-10-01 Impact factor: 3.427
Authors: Emanuele Pontali; Denise Rossato Silva; Florian M Marx; Jose Antonio Caminero; Rosella Centis; Lia D'Ambrosio; Jose Maria Garcia-Garcia; Jeremiah Chakaya Muhwa; Simon Tiberi; Giovanni Battista Migliori Journal: Arch Bronconeumol Date: 2022-06-10 Impact factor: 6.333
Authors: Denise Rossato Silva; Alana Ambos Freitas; Amanda Reis Guimarães; Lia D'Ambrosio; Rosella Centis; Marcela Muñoz-Torrico; Dina Visca; Giovanni Battista Migliori Journal: J Bras Pneumol Date: 2022-05-13 Impact factor: 2.800
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 Journal: Int J Tuberc Lung Dis Date: 2021-04-01 Impact factor: 2.373