Post Tubercular Lung Disease (PTLD) Morbidity Among Treated Cases of Pulmonary Tuberculosis From Rural India

Abstract Rational Treated PTB patients contribute to the growing global burden of chronic respiratory morbidity. NTEP lack structured care beyond treatment completion, highlighting the need for increased awareness and research efforts to address the long-term needs of TB survivors. The present study was conducted at tertiary healthcare center to assess Pulmonary Function Tests and clinical, radiological factors in post tubercular lung disease at end of treatment, 3 months and 6 months threreafter. Methods Ethics committee approval was obtained. Patients more than 12 years who had completed their treatment for pulmonary tuberculosis were assessed over a follow-up period of six months. Patients were evaluated at three intervals: after treatment completion (within 2 weeks), after three months and after six months, using chest X-rays, six minute walk test and spirometry (PFT) with bronchodilator response testing. Pulmonary function was measured using the MIR Spirobank PFT machine, Pulmonary function tests (PFTs) were categorized into normal, obstructive, restrictive, or mixed patterns, Results All 77 patient were treated with DS TB treatment regimen. Dyspnea was predominant symptom after recovery from pulmonary TB which was compared using Modified Borg Dyspnea Scale table 1 Functional assessment using the 6-minute walk test showed a significant improvement in physical endurance over time. table2 X-ray Grading System (According to The Modified Chest X-ray Scoring System) classified the severity of lung disease among 77 patients using an X-ray grading system. After completion of treatment about 72(93.5%) patients were having mild disease, and 5 (6.5%)patients with moderate disease.table 3 After enrollment in study 25 patients were unable to complete follow up visit after 3 and 6 months. About 23 (44.3%) of 52 patients were having abnormal PFT at the end of 6 months. Obstructive pattern was predominantly seen in 14 patients at the end of 6 months after treatment completion. Conclusions Residual clinical symptoms and incomplete recovery of PFT and X-ray findings over the period of 6 months after treatment completion in treated cases underscores the importance of continued follow-up and rehabilitation. Patients with obstructive pattern on PFT at the end of 6 months of treatment can be labelled as post TB obstructive airway disease (PT OAD) and needs further investigations and long term treatment in the form of inhaled bronchodilators. Functional assessment and rehabilitation should be part of TB treatment under NTEP. (National Tuberculosis Elimination Program)