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Lung function trajectories in children with pulmonary TB and non-TB lower respiratory tract infections
I J Courtney1, M Palmer1, R Swanepoel2
1Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Insights
Children with pulmonary tuberculosis (TB) and non-TB lower respiratory tract infections (LRTIs) showed similar lung function decline over one year, with reduced forced vital capacity (FVC) in TB patients compared to controls.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Respiratory Medicine
Background:
- Longitudinal study comparing lung function in pediatric pulmonary tuberculosis (PTB), non-TB lower respiratory tract infections (LRTIs), and healthy controls.
- Investigated long-term respiratory health outcomes in children affected by TB and other respiratory illnesses.
Purpose of the Study:
- To compare lung function trajectories in children diagnosed with PTB versus non-TB LRTIs and healthy controls over a 52-week period.
- To assess the impact of PTB and LRTIs on lung function parameters in children.
Main Methods:
- Included children aged 4-13 years capable of spirometry, with groups for TB, non-TB LRTIs, and healthy controls.
- Spirometry (FEV1, FVC, FEV1/FVC) was performed at baseline and over 52 weeks using Global Lung Initiative reference ranges.
- Classified children based on careful evaluation and follow-up for TB and non-TB LRTIs.
Main Results:
- 143 children (46 TB, 64 non-TB LRTIs, 33 controls) were analyzed; 7% were HIV-positive.
- Restrictive spirometry patterns were prevalent in both symptomatic groups post-follow-up.
- Both TB and non-TB LRTI groups showed decreased FEV1 and FVC compared to controls, with significantly lower FVC in the TB group.
Conclusions:
- Lung function trajectories were comparable between children with PTB and non-TB LRTIs.
- Children with PTB and non-TB LRTIs exhibited reduced forced vital capacity (FVC) one year after diagnosis.
Background:
This longitudinal study compared lung function in children with pulmonary TB (PTB), children with non-TB lower respiratory tract infections (LRTIs) and healthy controls.
Methods:
Children aged 4-13 years presenting with presumed PTB and their healthy siblings who could perform spirometry were included. Children were classified as having TB, non-TB LRTIs after careful evaluation and during follow-up. Spirometry measurements were completed at baseline and at subsequent study visits during 52 weeks of follow-up. Measurements included forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC using 2022 race-neutral Global Lung Initiative reference ranges.
Results:
Of 143 children, 46 had TB, 64 had non-TB LRTIs, and 33 were healthy controls. The median age was 6 years (IQR 5-9) and 10 (7%) were living with HIV. Restrictive spirometry patterns were common in both symptomatic groups at the end of follow-up, with a significantly lower FVC in children with TB compared to controls. In multivariable analysis adjusted for time and study group, FEV1 and FVC decreased for both the TB and non-TB LRTI groups, compared to healthy controls.
Conclusion:
Lung-function trajectories were similar between children with TB and non-TB LRTI, with low FVC one-year after diagnosis.
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