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

• Published in: Pediatric pulmonology Vol. 59; no. 7; pp. 1912 - 1921
• Main Authors: Nkereuwem, Esin, Agbla, Schadrac, Njai, Bintou, Edem, Victory Fabian, Jatta, Muhammed Lamin, Owolabi, Olumuyiwa, Masterton, Uma, Jah, Fatoumatta, Danso, Madikoi, Fofana, Aunty Nyima, Samateh, Wandifa, Darboe, Muhammed Lamin, Owusu, Sheila Ageiwaa, Bush, Andrew, Kampmann, Beate, Togun, Toyin
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.07.2024
• Subjects: Adolescent; Child; childhood tuberculosis; Cross-Sectional Studies; Female; Gambia - epidemiology; Humans; lung function; Male; post‐tuberculosis; Prevalence; respiratory impairment; sequelae; Spirometry; Teenagers; Tuberculosis; Tuberculosis, Pulmonary - complications; Tuberculosis, Pulmonary - epidemiology; Gambia; sequelae; lung function; spirometry; respiratory impairment; post‐tuberculosis; childhood tuberculosis
• ISSN: 8755-6863; 1099-0496; 1099-0496
• DOI: 10.1002/ppul.27009

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.