Impaired Lung Function and Quality of Life Outcomes in Patients with Tuberculosis: A Cross-Sectional Study

Abstract

Tuberculosis (TB) continues to be the world's deadliest infectious disease, with an estimated 10.8 million new cases reported in 2023, of which India alone accounted for 28% of the global burden. This study aims to evaluate the impact of tuberculosis on pulmonary function and exercise tolerance, and to examine how these impairments affect health-related quality of life (HRQoL). In a cross-sectional design, 96 bacteriologically confirmed TB patients and 96 age- and sex-matched community controls underwent spirometry, six-minute-walk test (6 MWT), and HRQoL evaluation. DR-TB was detected in 27 patients (28.1%): Isoniazid monoresistance 59.3%, rifampicin monoresistance 11.1%, and XDR-TB 29.6%. Dyspnoea (70.8%) and cough (37.5%) were the most commonly reported symptoms among TB patients. Mean values of FEV₁, FVC, and FEV₁/FVC were significantly lower in TB patients compared to controls (62.8%, 65.97%, and 70.08% vs. 82.55%, 80.09%, and 78.08%, respectively; p < 0.001). Recurrent or DR-TB was associated with reduced spirometric indices and 6 MWT distances (241 m vs. 358 m in drug-sensitive TB). St. George's respiratory questionnaire (SGRQ) scores indicated significantly poorer health-related quality of life (HRQoL) in patients compared to controls across all domains-symptoms (23.7 vs. 10.7), activity (33.3 vs. 14.2), and impact (20.6 vs. 9.4; p < 0.05). SGRQ scores were inversely correlated with lung function parameters (r = -0.42 to -0.56). These findings underscore the persistent health burden TB poses post-therapy, highlighting the need for routine post-TB functional screening and robust DR-TB control to achieve End-TB goals.

Keywords: drug-resistant tuberculosis; quality of life; tuberculosis.

Figure 1

Distribution of age among the participants in the study.

Figure 2

Distribution of disease symptoms among the TB-affected subjects in the study. Loa—loss of appetite.

Figure 3

Distribution of the spirometry results (PFT values) among the healthy and TB-affected subjects in the study.

Figure 4

Distribution of spirometry results (PFT values) among TB-affected subjects by antimicrobial resistance status.

Figure 5

Distribution of mean SGRQ scores across the healthy and TB-affected subjects in the study.

Figure 6

Distribution of mean SGRQ scores among TB-affected subjects by antimicrobial resistance status.

Figure 7

Pearson’s correlation values between PFT values and SGRQ scores among TB-affected individuals in the study.