Pulmonary impairment after tuberculosis

Jotam G. Pasipanodya, Thaddeus L. Miller, Mauricio Vecino, Guadalupe Munguia, Robert Garmon, Sejong Bae, Gerry Drewyer, Stephen Weis

Research output: Contribution to journalArticleResearchpeer-review

106 Citations (Scopus)

Abstract

Background: Pulmonary impairment subsequent to a cure of pulmonary tuberculosis has been described only in selected populations. Methods: We compared pulmonary function in a case-control study of 107 prospectively identified patients with pulmonary tuberculosis who had completed at least 20 weeks of therapy and 210 patients with latent tuberculosis infection (LTBI). Results: Both groups had similar risk factors for pulmonary impairment. Impairment was present in 59% of tuberculosis subjects and 20% of LTBI control subjects. FVC, FEV1, FEV1/FVC ratio, and the midexpiratory phase of forced expiratory flow were significandy lower in the treated pulmonary tuberculosis patients than in the comparison group. Ten patients with a history of pulmonary tuberculosis (9.4%) had less than half of their expected vital capacity vs one patient (0.53%) in the LTBI group. Another 42 patients (39%) with tuberculosis had between 20% and 50% of the expected vital capacity vs 36 patients with LTBI (17%). After adjusting for risk, survivors of tuberculosis were 5.4 times more likely to have abnormal pulmonary function test results than were LTBI patients (p > 0.001; 95% confidence interval, 2.98 to 9.68). Birth in the United States (odds ratio [OR], 2.64; p = 0.003) and age (OR, 1.03; p = 0.005) increased the odds of impairment. Pulmonary impairment was more common in cigarette smokers; however, after adjusting for demographic and other risk factors, the difference did not reach statistical significance (p = 0.074). Conclusions: These findings indicate that pulmonary impairment after tuberculosis is associated with disability worldwide and support more aggressive case prevention strategies and posttreatment evaluation. For many persons with tuberculosis, a microbiological cure is the beginning not the end of their illness.

Original languageEnglish
Pages (from-to)1817-1824
Number of pages8
JournalChest
Volume131
Issue number6
DOIs
StatePublished - 1 Jan 2007

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Latent Tuberculosis
Tuberculosis
Lung
Pulmonary Tuberculosis
Vital Capacity
Odds Ratio
Respiratory Function Tests
Infection Control
Tobacco Products
Survivors
Case-Control Studies
Demography
Parturition
Confidence Intervals
Population

Keywords

  • Disability
  • Impairment
  • Pulmonary function
  • Tuberculosis

Cite this

Pasipanodya, J. G., Miller, T. L., Vecino, M., Munguia, G., Garmon, R., Bae, S., ... Weis, S. (2007). Pulmonary impairment after tuberculosis. Chest, 131(6), 1817-1824. https://doi.org/10.1378/chest.06-2949
Pasipanodya, Jotam G. ; Miller, Thaddeus L. ; Vecino, Mauricio ; Munguia, Guadalupe ; Garmon, Robert ; Bae, Sejong ; Drewyer, Gerry ; Weis, Stephen. / Pulmonary impairment after tuberculosis. In: Chest. 2007 ; Vol. 131, No. 6. pp. 1817-1824.
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Pasipanodya, JG, Miller, TL, Vecino, M, Munguia, G, Garmon, R, Bae, S, Drewyer, G & Weis, S 2007, 'Pulmonary impairment after tuberculosis', Chest, vol. 131, no. 6, pp. 1817-1824. https://doi.org/10.1378/chest.06-2949

Pulmonary impairment after tuberculosis. / Pasipanodya, Jotam G.; Miller, Thaddeus L.; Vecino, Mauricio; Munguia, Guadalupe; Garmon, Robert; Bae, Sejong; Drewyer, Gerry; Weis, Stephen.

In: Chest, Vol. 131, No. 6, 01.01.2007, p. 1817-1824.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Miller, Thaddeus L.

AU - Vecino, Mauricio

AU - Munguia, Guadalupe

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AU - Drewyer, Gerry

AU - Weis, Stephen

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N2 - Background: Pulmonary impairment subsequent to a cure of pulmonary tuberculosis has been described only in selected populations. Methods: We compared pulmonary function in a case-control study of 107 prospectively identified patients with pulmonary tuberculosis who had completed at least 20 weeks of therapy and 210 patients with latent tuberculosis infection (LTBI). Results: Both groups had similar risk factors for pulmonary impairment. Impairment was present in 59% of tuberculosis subjects and 20% of LTBI control subjects. FVC, FEV1, FEV1/FVC ratio, and the midexpiratory phase of forced expiratory flow were significandy lower in the treated pulmonary tuberculosis patients than in the comparison group. Ten patients with a history of pulmonary tuberculosis (9.4%) had less than half of their expected vital capacity vs one patient (0.53%) in the LTBI group. Another 42 patients (39%) with tuberculosis had between 20% and 50% of the expected vital capacity vs 36 patients with LTBI (17%). After adjusting for risk, survivors of tuberculosis were 5.4 times more likely to have abnormal pulmonary function test results than were LTBI patients (p > 0.001; 95% confidence interval, 2.98 to 9.68). Birth in the United States (odds ratio [OR], 2.64; p = 0.003) and age (OR, 1.03; p = 0.005) increased the odds of impairment. Pulmonary impairment was more common in cigarette smokers; however, after adjusting for demographic and other risk factors, the difference did not reach statistical significance (p = 0.074). Conclusions: These findings indicate that pulmonary impairment after tuberculosis is associated with disability worldwide and support more aggressive case prevention strategies and posttreatment evaluation. For many persons with tuberculosis, a microbiological cure is the beginning not the end of their illness.

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Pasipanodya JG, Miller TL, Vecino M, Munguia G, Garmon R, Bae S et al. Pulmonary impairment after tuberculosis. Chest. 2007 Jan 1;131(6):1817-1824. https://doi.org/10.1378/chest.06-2949