Post-tuberculosis lung health: perspectives from the First International Symposium

Author:

Allwood B. W.1,van der Zalm M. M.2,Amaral A. F. S.3,Byrne A.4,Datta S.5,Egere U.6,Evans C. A.5,Evans D.7,Gray D. M8,Hoddinott G.2,Ivanova O.9,Jones R.10,Makanda G.11,Marx F. M.12,Meghji J.13,Mpagama S.14,Pasipanodya J. G.15,Rachow A.16,Schoeman I.11,Shaw J.1,Stek C.17,van Kampen S.18,von Delft D.11,Walker N. F.19,Wallis R. S.20,Mortimer K.21

Affiliation:

1. Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg

2. Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa

3. National Heart and Lung Institute, Imperial College London, London, UK

4. Heart Lung Clinic, St Vincent´s Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia

5. Department of Infectious Disease, Imperial College London, London, UK, Innovation For Health And Development, Laboratory for Research and Development, Universidad Peruana Cayetano Heredia, Lima, Innovacion por la Salud y el Desarollo, Asociación Benéfica Prisma, Lima, Peru

6. IMPALA Consortium and Community Health Systems Group, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK

7. Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg

8. Division of Paediatric Pulmonology, Department of Paediatrics, University of Cape Town, Cape Town, South Africa

9. Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany

10. Faculty of Health, Plymouth University, Plymouth, UK

11. TB Proof, Cape Town, South Africa

12. Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa, DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Faculty of Science, Stellenbosch University, Johannesburg, South Africa

13. Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK

14. Kibong´oto Infectious Diseases Hospital, Kibong´oto, Tanzania

15. Center for Infectious Diseases Research & Experimental Therapeutics, Texas Tech University Health Sciences Center, Dallas, TX, USA

16. Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany, German Centre for Infection Research (DFIZ), Partner Site Munich, Munich, Germany

17. Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

18. Leiden University Medical Center, Leiden, The Netherlands

19. Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK

20. Aurum Institute, Johannesburg, South Africa

21. Liverpool School of Tropical Medicine, Liverpool, UK, International Union against Tuberculosis and Lung Disease, Paris, France

Abstract

ALTHOUGH CURABLE, TB frequently leaves the individual with chronic physical and psycho-social impairment, but these consequences have been largely neglected. The 1st International Post-Tuberculosis Symposium (Stellenbosch, South Africa) was held to discuss priorities and gaps in addressing this issue. A barrier to progress has been the varied terminology and nomenclature, so the Delphi process was used to achieve consensus on definitions. Lack of sufficient evidence hampered definitive recommendations in most domains, including prevention and treatment of post-TB lung disease (PTLD), but the discussions clarified the research needed. A consensus was reached on a toolkit for future PTLD measurement and on PTLD patterns to be considered. The importance of extra-pulmonary consequences and progressive impairment throughout the life-course was identified, including TB recurrence and increased mortality. Patient advocates emphasised the need to address the psychological and social impacts post TB and called for clinical guidance. More generally, there is an urgent need for increased awareness and research into post-TB complications.

Publisher

International Union Against Tuberculosis and Lung Disease

Subject

Infectious Diseases,Pulmonary and Respiratory Medicine

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