Spirometry after treatment completion for pulmonary tuberculosis - a necessity?

Pulmonary tuberculosis often results in permanent lung damage, such as fibrosis, bronchiectasis, and emphysema, despite a successful microbiological cure. These structural changes lead to post-tuberculosis lung disease (PTLD), which is characterized by chronic respiratory symptoms and impaired lung function. This study aimed to evaluate functional and radiological impairments in patients after completion of anti-tubercular therapy to understand the long-term impact of tuberculosis on respiratory health. This prospective study evaluated 175 adults within 1 year of completing anti-tubercular therapy to assess the prevalence of PTLD. Results revealed spirometric abnormalities in 57.1% of participants, predominantly restrictive patterns (30.3%), followed by obstructive defects (16.6%) and Preserved Ratio Impaired Spirometry or PRISm (10.3%). Sputum smear positive status at diagnosis strongly predicted obstructive disease and severe structural damage. Notably, this impairment affected a young, non-smoking cohort and was largely irreversible. The study concludes that microbiological cure does not equate to respiratory health, highlighting the necessity of integrating assessment of comprehensive respiratory system evaluation and routine spirometry at treatment completion to manage long-term morbidity.