Pulmonary Outcomes and Lung Function in Tuberculosis

Tuberculosis often leaves survivors with lasting structural and functional lung damage despite microbiological cure. Common sequelae include airflow obstruction, restrictive defects, bronchiectasis and fibrotic scarring, which manifest as reduced exercise capacity, persistent dyspnoea and diminished quality of life. Emerging data indicate that drug-resistant strains, particularly rifampicin-resistant tuberculosis, carry an elevated long-term disability burden. Advanced imaging modalities and refined spirometric assessments have shed light on the patterns and mechanisms of post-tuberculosis lung injury, while host-directed therapies are being explored to mitigate inflammatory damage. At a population level, the inclusion of post-tuberculosis sequelae in disease burden estimates has profound implications for health policy, resource allocation and the design of rehabilitation services. Multidisciplinary research efforts are now focusing on translating these insights into practical clinical guidelines, ensuring that survivors receive systematic evaluation and targeted interventions to optimise respiratory outcomes over the life course.

Research from Nature Portfolio

Mathematical modelling of the lifetime burden of rifampicin-resistant tuberculosis has revealed that incident cases in 2020 accounted for millions of disability-adjusted life years, with nearly half of this burden accruing after treatment completion. On average, individuals with resistant disease experienced a substantially greater long-term reduction in health status than those with drug-susceptible infection. Geographic analyses identified former Soviet Union and southern African regions as hotspots of post-treatment disability, highlighting stark inequities in pulmonary outcomes. These findings underscore the necessity of integrating long-term care into tuberculosis control strategies and investing in interventions that prevent resistance emergence and transmission.

Pulmonary Outcomes and Lung Function in Tuberculosis publication trend

The graph below shows the total number of articles in pulmonary outcomes and lung function in tuberculosis across all publications each year (not limited to Nature Index journals).

Technical terms

FEV1: Forced expiratory volume in one second, the volume of air exhaled during the first second of a forced breath.

FVC: Forced vital capacity, the total volume of air exhaled during a full forced breath.

Bronchiectasis: Irreversible dilatation of the bronchi associated with chronic inflammation and mucus retention.

Spirometry: A lung function test that measures volumes and flow rates during inhalation and exhalation.

Post-tuberculosis lung disease (PTLD): A spectrum of chronic respiratory impairments that persist or develop after completion of tuberculosis treatment.

References

1. Global burden of disease due to rifampicin-resistant tuberculosis: a mathematical modeling analysis. Nature Communications (2023).
2. Post-tuberculosis lung impairment: systematic review and meta-analysis of spirometry data from 14 621 people. European Respiratory Review (2023).
3. Patient outcomes associated with post-tuberculosis lung damage in Malawi: a prospective cohort study. Thorax (2020).
4. A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease. PLOS ONE (2016).
5. Lifetime burden of disease due to incident tuberculosis: a global reappraisal including post-tuberculosis sequelae. The Lancet Global Health (2021).
6. Clinical standards for the assessment, management and rehabilitation of post-TB lung disease. The International Journal of Tuberculosis and Lung Disease (2021).
7. Adjunctive host-directed therapies for pulmonary tuberculosis: a prospective, open-label, phase 2, randomised controlled trial. The Lancet Respiratory Medicine (2021).