Post-tuberculosis respiratory impairment in Gambian children and adolescents: A cross-sectional analysis.

Esin Nkereuwem ORCID logo ; Schadrac Agbla ORCID logo ; Bintou Njai ; Victory Fabian Edem ORCID logo ; Muhammed Lamin Jatta ; Olumuyiwa Owolabi ; Uma Masterton ; Fatoumatta Jah ; Madikoi Danso ; Aunty Nyima Fofana ; +6 more... Wandifa Samateh ; Muhammed Lamin Darboe ; Sheila Ageiwaa Owusu ORCID logo ; Andrew Bush ; Beate Kampmann ORCID logo ; Toyin Togun ORCID logo ; (2024) Post-tuberculosis respiratory impairment in Gambian children and adolescents: A cross-sectional analysis. Pediatric pulmonology, 59 (7). pp. 1912-1921. ISSN 8755-6863 DOI: 10.1002/ppul.27009
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BACKGROUND: Although post-tuberculosis lung disease (PTLD) is a known consequence of pulmonary tuberculosis (pTB), few studies have reported the prevalence and spectrum of PTLD in children and adolescents. METHODS: Children and adolescent (≤19 years) survivors of pTB in the Western Regions of The Gambia underwent a respiratory symptom screening, chest X-ray (CXR) and spirometry at TB treatment completion. Variables associated with lung function impairment were identified through logistic regression models. RESULTS: Between March 2022 and July 2023, 79 participants were recruited. The median age was 15.6 years (IQR: 11.8, 17.9); the majority, 53/79 (67.1%), were treated for bacteriologically confirmed pTB, and 8/79 (10.1%) were children and adolescents living with HIV. At pTB treatment completion, 28/79 (35.4%) reported respiratory symptoms, 37/78 (47.4%) had radiological sequelae, and 45/79 (57.0%) had abnormal spirometry. The most common respiratory sequelae were cough (21/79, 26.6%), fibrosis on CXR (22/78, 28.2%), and restrictive spirometry (41/79, 51.9%). Age at TB diagnosis over ten years, undernutrition and fibrosis on CXR at treatment completion were significantly associated with abnormal spirometry (p = .050, .004, and .038, respectively). CONCLUSION: Chronic respiratory symptoms, abnormal CXR, and impaired lung function are common and under-reported consequences of pTB in children and adolescents. Post-TB evaluation and monitoring may be necessary to improve patient outcomes.


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