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. 2025 Jun 4;15(2):82-87.
doi: 10.5588/pha.25.0001. eCollection 2025 Jun.

Pulmonary rehabilitation for post-TB lung disease led by TB survivors

F J Mtei  1 , I Meadows  2 , K Msaji  1 , F Thobias  1 , A Liyoyo  1 , A Kimaro  1 , P M Joseph  1 , C Gitige  1 , O Kaswaga  1 , S Matoi  1 , A Ngoma  1 , A Mbuya  1   3 , P Mbelele  1 , L Ritte  1 , L Subi  1 , P Neema  4 , R Kisonga  4 , D Mbwana  5 , E Mpolya  6 , M Drage  7 , L I Lochting  7 , S K Heysell  2 , S G Mpagama  1
Affiliations

Pulmonary rehabilitation for post-TB lung disease led by TB survivors

F J Mtei et al. Public Health Action. .

Abstract

Background: Post-TB patients often experience persistent lung issues that impair exercise capacity and quality of life. Although pulmonary rehabilitation is known to be effective for chronic lung diseases, its role in post-TB lung disease remains underexplored in high TB-burden settings.

Method: This prospective study (2021-2022) in Tanzania's Kilimanjaro region evaluated a 24-week, community-based pulmonary rehabilitation program led by TB survivors for adults with moderate-to-severe respiratory symptoms despite TB cure. The program included supervised exercise, breathing training, psychosocial support and smoking cessation. Outcomes measured at baseline, 12 weeks, and 24 weeks included spirometry, 6-minute walk distance (6MWD), St. George's Respiratory Questionnaire (SGRQ), BMI, Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9).

Results: Among 121 participants (mean age 48±8.67 years, 89.2% male), significant improvements were observed in 6MWD (420 vs. 460 meters, p < 0.001) and SGRQ scores (34.63 to 12.99, p < 0.001). Smoking history predicted SGRQ improvement. Although no changes were seen in lung function or BMI, anxiety and depression symptoms improved in those with abnormal baseline scores.

Conclusion: Community-based pulmonary rehabilitation improved symptomatic individuals' quality of life, physical capacity and mental health. Future research should refine intervention timing and evaluate long-term outcomes across diverse settings.

Keywords: 6 minute walk distance (6MWD); SGRQ; St Georges respiratory questionnaires; Tanzania; lung health; pulmonary function test; tuberculosis.

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Conflict of interest statement

Conflicts of interest: none declared.

Figures

FIGURE 1.
FIGURE 1.
Screening and enrollment of participants. PTLD = post-TB lung disease; PR = Pulmonary rehabilitation; mMRC = Modified Medical Research Council dyspnea scale.
FIGURE 2.
FIGURE 2.
St. George’s Respiratory Questionnaire (SGRQ), SGRQ-total score at baseline, week 12, and week 24, showing improved quality of life following pulmonary rehabilitation.
FIGURE 3.
FIGURE 3.
Six-minute walk distance (6MWD) improvements were observed from baseline through weeks 12 and 24 of rehabilitation.
See this image and copyright information in PMC

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