# Pulmonary Tuberculosis-Associated Morbidity in Africa: A Systematic Review

## TL;DR

This study reviews the health problems linked to pulmonary tuberculosis in Africa, focusing on mental health, lung issues, and other comorbidities.

## Contribution

The study highlights unique TB-related morbidities like secondary amenorrhea and medication-induced psychosis in African populations.

## Key findings

- Mental illness was the most reported morbidity among pulmonary TB patients in Africa.
- Comorbidities like HIV, diabetes, and chronic pulmonary conditions worsen TB outcomes.
- Unique conditions such as secondary amenorrhea and medication-induced psychosis were identified as TB-related complications.

## Abstract

Tuberculosis (TB) remains a global health problem despite the availability of effective medications and preventive measures. TB in humans is caused by Mycobacterium tuberculosis (MTB) and usually affects the lungs causing pulmonary TB. It is transmitted via M. tuberculosis-containing aerosol droplets and nuclei. TB has a devastating effect on Africa and this review aims to identify the most common morbidities associated with and the sequelae/complications of pulmonary TB in Africa and also explore a management option to decrease the impact of morbidity/complications and increase quality of life.

A comprehensive search conducted from inception to the 5th of December 2024 on PubMed, Scopus, and African Journal Online returned 6312 for which 1441 duplicates were removed. Four thousand, eight hundred seventy-one articles were screened and 4791 articles were removed following title and abstract screening, 80 articles were subjected to full-text screening, and ultimately, 17 articles met the requirements for the inclusion criteria which included original articles published in English in peer-reviewed journals from inception to November 2024 that reported morbidity/sequelae among patients of all ages and genders in Africa diagnosed with pulmonary TB via culture and currently receiving treatment and or have completed standardized treatment.

From the 17 articles, a total of 4552 patients were included from 11 different African countries. There were 2358 males and 1918 females diagnosed with pulmonary TB for which mental illness was the most reported morbidity (depression, psychological distress, generalized anxiety, adjustment disorder, schizophrenia, psychosis) followed by lung impairment and then airway obstruction. Other comorbidities were HIV, asthma, and chronic obstructive pulmonary airway disease, diabetes, chicken pox, and heart-related disease.

This study highlighted the profound impact of TB on mental health, respiratory function, and systemic health exacerbated by comorbidities such as HIV, diabetes, and chronic pulmonary conditions. Additionally, the review reveals unique morbidities like secondary amenorrhea and medication-induced psychosis, often overlooked in global TB research.