Tuberculosis survivors at higher risk of developing lung damage

Tuberculosis (TB) survivors, especially those living in India, are at a higher risk of developing lasting damage to lungs, according to a study done on more than 2,000 Indian patients.

Published in the Lancet Global Health, the study has found that more than one-third of patients who are successfully cured of TB with antibiotics developed permanent lung damage, which, in the worst cases, results in large holes in the lungs called cavities and widens the airways called bronchiectasis.

According to the World Health Organisation's Global TB Report 2018, an estimated 2.8 million people have contracted TB in India which represents one quarter of all TB cases worldwide.

"This study calls urgent attention to the problem of post-TB lung damage worldwide. TB is a curable condition with antibiotics and great steps forward have been made towards eliminating the disease," said study lead author James Chalmers, Professor at the University of Dundee.

"But this study is a wakeup call because even if we manage to eliminate all TB worldwide tomorrow, we are going to be left with a legacy of chronic lung damage and bronchiectasis which will require better recognition and better treatment," he said.

For the study, the research team recruited 2,195 patients with established bronchiectasis from 14 Indian states.

TB survivors and patients with a history of severe infections such as childhood pneumonia made up the majority of patients with lung damage in India. The researchers found that these infections left a legacy of daily cough, further chest infections and poor quality of life.

Patients required further hospitalisations for treatment of their lung conditions in nearly 40 per cent of cases. Patients with post-TB lung damage had lost approximately 40 per cent of their lung capacity, leaving many patients with persistent breathlessness.

Compared with patients in Europe and the US, those in India had more severe lung damage, lung function was worse and patients were more likely to be hospitalised for severe infections.

Recommended treatment for these patients such as inhalers, physiotherapy and antibiotic treatment for infections were rarely provided.

Physiotherapy exercises and antibiotics are inexpensive treatments which are proven to improve quality of life and reduce lung infections, but were available to less than 50 per cent of Indian patients.

The Indian government has pledged to eradicate TB by 2025, however this study warns that the TB epidemic could have lasting consequences for the treatment of lung conditions.