PREVALENCE OF POST-TUBERCULOSIS LUNG DISEASE (PTLD) IN PATIENTS ATTENDING RESPIRATORY OUTPATIENT DEPARTMENTS AT A TERTIARY CARE HOSPITAL IN RAJASTHAN
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Keywords
Post-tuberculosis lung disease; Pulmonary tuberculosis; Spirometry; Respiratory morbidity; Tertiary care hospital
Abstract
Background: Advances in tuberculosis (TB) diagnosis and treatment have led to improved survival; however, a considerable proportion of TB survivors experience persistent respiratory impairment known as post-tuberculosis lung disease (PTLD). PTLD encompasses a range of chronic structural and functional lung abnormalities that adversely affect quality of life and long-term health outcomes. Data on PTLD prevalence and patterns remain limited in many high-burden regions, including Rajasthan.
Objectives: To estimate the prevalence of post-tuberculosis lung disease among patients attending a respiratory outpatient department at a tertiary care hospital in Rajasthan, and to describe their clinical, radiological, and spirometric profiles, along with factors associated with PTLD.
Methods: A hospital-based cross-sectional study was conducted from January 2023 to June 2024 in the respiratory outpatient department of a tertiary care hospital in Rajasthan. Adults aged ≥18 years with a history of microbiologically confirmed pulmonary TB who had completed anti-tuberculosis treatment at least six months prior were enrolled using consecutive sampling. Sociodemographic details, TB-related history, risk factors, clinical symptoms, and comorbidities were recorded using a structured proforma. All participants underwent chest radiography, and spirometry was performed according to ATS/ERS guidelines. PTLD was defined as the presence of persistent respiratory symptoms, radiological sequelae, and/or abnormal spirometry after exclusion of active TB. Data were analyzed using descriptive statistics and inferential tests, including chi-square test and logistic regression.
Results: Out of 240 participants, 86 patients (35.8%) were identified as having PTLD. Persistent respiratory symptoms were present in 83.7% of PTLD patients, radiological abnormalities in 75.6%, and spirometric abnormalities in 80.2%. Among those with abnormal spirometry, obstructive patterns were most common (49.3%), followed by restrictive (30.4%) and mixed defects (20.3%). PTLD was more frequently observed among older individuals, smokers, those with recurrent TB episodes, and patients with a history of drug-resistant TB.
Conclusions: PTLD is common among post-TB patients attending tertiary respiratory services. Routine post-treatment assessment and long-term follow-up should be integrated into TB care to address the growing burden of chronic respiratory morbidity.
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Dr. Ganeshee Lal Sharma
Associate Professor, Department of Respiratory Medicine, Shri Kalyan
Government Medical College, Sikar, Rajasthan, India.
Dr. Ravi Panwar
Associate Professor, Department of Respiratory Medicine, PDU Medical College
, Churu, Rajasthan, India.
Dr. Rajender Singh
Assistant Professor, Department of Respiratory Medicine, PDU Medical College,
Churu, Rajasthan, India.
Dr. Mahesh Mahich
Assistant Professor, Department of Respiratory Medicine, RNT Medical College,
Udaipur, Rajasthan, India.
Dr. Hanuman Jaipal
Senior Professor, Department of General Medicine, PDU Medical College,
Churu, Rajasthan, India.
Dr. Jatin Prajapati
Senior Resident, Department of Community Medicine, World College of Medical Sciences & Research, Jhajjar, Haryana, India. (ORCID: https://orcid.org/0009-0004-7298-4499 )
