Compelling evidence shows that tuberculosis (TB) can have a ‘profound’ and ‘lasting’ impact on the lungs of those successfully treated for the disease, international researchers say.

The meta-analysis of 15 studies across 17 countries involving more than 75,000 individuals (aged 11-65 years) will be presented at the ESCMID Global Congress in Barcelona later this month.

The team, led by Dr Sharenja Ratnakumar, St George’s, University of London, found that compared to healthy controls, those with a history of TB fared significantly worse across all four measures of lung function analysed: FEV1, FVC, FEV1/FVC ratio and FVC as a percentage of the predicted value.

Data showed a more significant impact on FEV1, which was 230 millilitres lower than for healthy controls, than FVC, which was 140 millilitres lower, though both reductions were clinically significant and at a level linked with increased risk of cardiovascular and respiratory disease, the researchers noted.

The analysis also found that people successfully treated for TB had a 65% higher change of airflow obstruction than the comparator group.

“Our results strongly indicate that post-tuberculosis lung disease is an under-recognised global challenge – and one that has significant implications for clinical practice and policy,” said Dr Ratnakumar. “The focus, until now, has been on the treatment of acute TB, but even when treatment is successful, individuals can be left with significant lung damage”.

The findings highlight the urgent need for evidence-based guidance on the diagnosis, treatment and management of post-TB lung disease, given the vast number of people who survive the disease (74 million between 2020 and 2022), it’s growing incidence, and the ageing population, she said.

“Our study also provides compelling evidence that the long-term care of individuals with post-tuberculosis lung disease should be an explicit component of the WHO’s End TB strategy,” she stressed.