Evaluating disability, comorbidities and risk factors after TB treatment: an 18-24 month follow-up

Several countries have developed national strategic plans to address post-TB disability and comorbidities. However, their feasibility and added value within routine programmatic settings remain undocumented.

We followed up individuals who successfully completed TB treatment at 11 health facilities in China between 2022-2023. Within the programmatic setting, we assessed health status, on-going symptoms, comorbidities, risk factors and disability (measured by 6-minute walking test [6MWT]) 18-24 months after treatment completion.

Of 586 individuals who completed TB treatment, 503 (86%) were reassessed. Compared with end of TB treatment, there were significant increases in cough (11.0% versus 6.4%), untreated diabetes (3.2% versus <1.0%), high blood pressure (13.1% versus 8.9%), cigarette smoking (12.7% versus 5.2%) and excessive alcohol consumption (5.8% versus 1.2%). Other conditions remained similar with 27.0% still disabled (6MWT<400m). 78 (13%) patients died or were lost-to-follow-up, with risk factors at end of treatment including on-going symptoms (RR1.7, 95%CI 1.1-2.7), high blood pressure (RR2.3, 95%CI 1.2-4.1) and undernutrition (RR2.6, 95%CI 1.7-3.9). Nine patients had recurrent TB. Employment status remained unchanged, with 47.5% still unemployed 18-24 months later.

TB survivors experienced substantial multimorbidity 18-24 months post-TB treatment. Health services must integrate long-term care strategies to address these ongoing health challenges.