Post-tuberculosis lung disease

Tuberculosis (TB) burden concentrates in low-income settings and remains the leading global cause of death from a single infectious agent, despite that it is preventable and treatable. TB-associated lung diseases (TBALD), a broad range of respiratory abnormalities which can start before or during a TB episode, may increase morbidity. TBALD may persist after successful completion of TB treatment as post-TB lung disease (PTLD). PTLD varies in severity and is characterised by persistent respiratory symptoms and lung impairment that can significantly impact social activities, health-related quality of life, and long-term survival. Risk factors for PTLD include increasing age, smoking, HIV infection, delayed diagnosis, and poor socioeconomic conditions. Action to limit PTLD may be taken before TB develops through TB screening, early diagnosis and TB preventive treatment, during treatment of TB, and upon its completion. Early detection, clinical assessment, and tailored management (including smoking cessation, immunisation, addressing respiratory comorbidities, pulmonary rehabilitation and social protection) can mitigate impairment and disability. Healthcare providers and national programmes play a vital role through clinical follow-up, patient education, and integration of TBALD care into broader health and social protection services. Sustained funding and research are crucial for this and to develop new tools to enhance care.