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. 2024 Jul;59(7):1912-1921.
doi: 10.1002/ppul.27009. Epub 2024 Apr 17.

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

Esin Nkereuwem  1   2 , Schadrac Agbla  3   4 , Bintou Njai  1 , Victory Fabian Edem  1 , Muhammed Lamin Jatta  1 , Olumuyiwa Owolabi  1 , Uma Masterton  1 , Fatoumatta Jah  1 , Madikoi Danso  1 , Aunty Nyima Fofana  1 , Wandifa Samateh  5 , Muhammed Lamin Darboe  5 , Sheila Ageiwaa Owusu  1   2 , Andrew Bush  6   7 , Beate Kampmann  1   2   8 , Toyin Togun  1   2   9
Affiliations

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

Esin Nkereuwem et al. Pediatr Pulmonol. 2024 Jul.

Abstract

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.

Keywords: childhood tuberculosis; lung function; post‐tuberculosis; respiratory impairment; sequelae; spirometry.

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References

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