Post-tuberculosis lung disease: Addressing the policy gap.

Area of Science:

• Public Health
• Respiratory Medicine
• Infectious Diseases

Background:

• Tuberculosis (TB) treatment cures infection but often leads to long-term functional impairment.
• Post-tuberculosis lung disease (PTLD) affects over 50% of patients completing TB therapy, representing a significant global health burden.
• PTLD is largely unaddressed in current international and national TB policies and guidelines, despite its high prevalence and morbidity.

Purpose of the Study:

• To highlight the significant burden of PTLD as a long-term complication of TB.
• To advocate for the inclusion of PTLD in global TB policies and clinical guidelines.
• To emphasize the need for established standards in PTLD diagnosis and management.

Main Methods:

• Review of current TB treatment outcomes and patient morbidity.
• Analysis of existing international and national TB policies and guidelines.
• Assessment of the current approach to chronic respiratory impairment post-TB.

Main Results:

• Over half of patients completing TB therapy develop PTLD, a major cause of chronic respiratory impairment.
• PTLD is notably absent from major TB policy discussions and clinical management guidelines.
• There is a lack of established clinical standards for PTLD diagnosis and care.

Conclusions:

• Clear clinical standards for PTLD diagnosis and management are urgently needed.
• All patients completing TB therapy should be screened for PTLD.
• Integrating PTLD into chronic care, including access to inhalers and home oxygen, is crucial. Funders like The Global Fund should prioritize PTLD in their strategies and funding.