Post-tuberculosis lung disease: Addressing the policy gap

TL;DR

Many people who recover from tuberculosis still suffer from chronic lung disease, but this issue is ignored in global health policies and needs urgent attention.

Contribution

The paper highlights the policy gap in addressing post-tuberculosis lung disease and proposes actionable solutions for its management.

Findings

Over half of TB patients who complete treatment have chronic respiratory impairment.

PTLD is largely absent from international and national TB policies and guidelines.

Including PTLD in funding strategies could improve long-term care for TB survivors.

Abstract

The burden of long-term functional impairment following curative treatment for tuberculosis (TB) constitutes a significant global health problem. By some estimates, chronic respiratory impairment, or post-tuberculosis lung disease (PTLD), is present in just over half of all patients who have completed TB therapy. Despite this high prevalence and substantial associated morbidity, discussion of PTLD is essentially absent from international and national TB policies and guidelines. Clear and ambitious clinical standards should be established for the diagnosis and management of PTLD, including the stipulation that all patients completing TB therapy should be screened for PTLD. Patients diagnosed with PTLD should receive linkage to chronic care, with access to inhalers and home oxygen, as indicated based on individual symptoms and pathophysiology. Leveraging their considerable influence, major funders, such as The Global Fund, could help close the gap in PTLD care by including PTLD in their strategic vision and funding streams. Immediate action is needed to address the substantial burden of disease associated with PTLD. This will require expanding the global approach to TB to include a commitment to diagnosing and treating long-term complications following initial curative therapy.