A study on association of obstructive airway disease in previously treated pulmonary tuberculosis patients

Abstract

Pulmonary tuberculosis (TB) and obstructive airway disease are of growing concern in a developing country akin to India. A considerable number of TB patients develop post-tubercular respiratory disease. There are few Indian studies assessing the relationship between antecedents of PTB and COPD. PTB has a considerable impact on quality of life. To evaluate the prevalence of obstructive airway disease in previously treated pulmonary tuberculosis patients and to evaluate the impact of post TB obstructive airway disease on QOL using SGRQ-C. A prospective, observational cross-sectional study was conducted in a tertiary care health centre over six months, enrolling 116 study subjects who met the inclusion criteria included after acquiring Informed consent. Study subjects had been categorized primarily based on prior history of PTB. Therefore, this study involved two groups of study subjects, PTB associated COPD and COPD. Subjects were assessed for PFT through the aid of MIR Spirobank smart App and QOL using SGRQ-C scale. Of 116 patients, 19(22.6%) women and 65(77.4%) men and 5(15.6%) women and 27(84.4%) men were diagnosed as PTB associated COPD and COPD respectively. Dyspnea and cough with sputum were the most common symptoms presented by 76(94.04%) and 62(71.42%) patients respectively. The effect of airflow limitation (FEV1) was slightly increased in PTB associated COPD patients (25.65%) compared to COPD patients (26.4%) and study endpoint showed noteworthy decrease in QOL of PTB associated COPD(72%) patients compared to COPD(66.4%). PTB-associated COPD constitutes a significant proportion of COPD within clinical setting. It is an independent risk factor for OAD in extensive TB burden countries. The results indicated that early diagnosis, appropriate management and control of TB are as critical as smoking cessation for reducing OAD. Early identification of Post tubercular COPD and early initiation of treatment in these patients improve the QOL and reduces morbidity and mortality.