Lung function amongst first time drug sensitive Tuberculosis patients in a local community in the Western Cape Province, South Africa.

Graeme Meintjes, Seyi Ladele Amosun, Brian Allwood, Shamila Manie
Purpose:

This research study was part of a PhD project. The main purpose of the study was to establish that lung impairment is present in people with 1st time drug susceptible TB which could then result in chronic airway disease. For patients with chronic airway disease a continuum care in the form of pulmonary rehabilitation is well established. However, patients with TB have never had access to this care as they were viewed to be cured.   

Methods:

A cross-sectional study was conducted among 314 patients in a local community in South Africa with first-time drug-sensitive TB who completed at least 16 weeks of treatment. Participants underwent spirometry and were classified as either normal or abnormal (obstructive, restrictive, or mixed). 

Results:

Of the 314 patients, only 235 could perform acceptable spirometry. Abnormal lung function was present in nearly a third (32%) of patients. Restrictive abnormalities accounted for 15% (n-36), Obstructive 11% (n=25) and mixed 6% (n=15) respectively. Univariate regression analysis related to socio-economic and clinical characteristics identified female sex, primary education, age > 45 years, being HIV negative, and being obese as associations for abnormal lung function. However, multivariate logistic regression showed only being older, specifically in the age group of 56–65 years (p=0.02) and being obese (p=0.04) were significant and associated with abnormal lung function. 

Conclusion(s):

Abnormal lung function is present even in first-time drug-sensitive patients with TB. Further research to support the continuum of care is warranted. 

Implications:

Current management of patients with TB are only pharmacological with the assumption that microbial cure results in complete cure from the disease. These initial results indicate that patients despite microbial cure may have clinically significant lung function impairment which will negatively impact their quality of life, but may also incur addition health care costs if not managed correctly. Pulmonary rehabilitation for these patients may be the continuum of care needed to improve their quality of life and reduce the burden on the health care system. Aligned with the WHO Rehabilitation 2030 physiotherapist are well positioned to action this care.  

Funding acknowledgements:
SAMRC Bongani Mayosi National Health Scholarship Programme for PhDs, University of Cape Town Research Development Grant
Keywords:
rehabilitation
community
pulmonary
Primary topic:
Cardiorespiratory
Second topic:
Community based rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
University of Cape Town Human Research Ethics Committee
Provide the ethics approval number:
HREC REF NO:725/2015
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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