Tuberculosis care does not end at treatment completion— a perspective from tuberculosis survivors

Abstract

Tuberculosis survivors need comprehensive care to increase their quality of life beyond the completion of tuberculosis treatment. Socioeconomic and medical challenges are faced by many patients after being cured from tuberculosis. 1 Allwood B Van der Zalm M Makanda G Mortimer K The long shadow post-tuberculosis. Lancet Infect Dis. 2019; 19: 1170-1171 Summary Full Text Full Text PDF PubMed Scopus (16) Google Scholar A systematic review and meta-analysis by Kamila Romanowski and colleagues 2 Romanowski K Baumann B Basham CA Ahmad Khan F Fox GJ Johnston JC Long-term all-cause mortality in people treated for tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis. 2019; 19: 1129-1137 Summary Full Text Full Text PDF PubMed Scopus (51) Google Scholar found the force of mortality for tuberculosis survivors to be 2·91 (95% CI 2·21–3·84) times higher than in those who had never had tuberculosis. Post-tuberculosis lung damage negatively impacts many tuberculosis survivors' quality of life. 3 Meghji J Lesosky M Joekes E et al. Patient outcomes associated with post-tuberculosis lung damage in Malawi: a prospective cohort study. Thorax. 2020; 75: 269-278 Crossref PubMed Scopus (20) Google Scholar , 4 Daniels KJ Irusen E Pharaoh H Hanekom S Post-tuberculosis health-related quality of life, lung function and exercise capacity in a cured pulmonary tuberculosis population in the Breede Valley district, South Africa. S Afr J Physiother. 2019; 751319 Crossref PubMed Scopus (9) Google Scholar Unfortunately, patient care often ends alongside treatment completion, with no follow-up consultations to evaluate mental wellbeing or lung damage. Meghji and colleagues 3 Meghji J Lesosky M Joekes E et al. Patient outcomes associated with post-tuberculosis lung damage in Malawi: a prospective cohort study. Thorax. 2020; 75: 269-278 Crossref PubMed Scopus (20) Google Scholar documented that 246 (61%) of 405 tuberculosis survivors reported respiratory symptoms at the time of treatment completion and 113 (31%) of 368 reported respiratory symptoms 1 year after treatment completion. Mental health is also negatively affected for many tuberculosis survivors, emphasising the need for holistic care to support patients after tuberculosis. 5 Chin AT Rylance J Makumbirofa S et al. Chronic lung disease in adult recurrent tuberculosis survivors in Zimbabwe: a cohort study. Int J Tuberc Lung Dis. 2019; 23: 203-211 Crossref PubMed Scopus (19) Google Scholar Quantifying the global number of tuberculosis survivors: a modelling studyThe number of tuberculosis survivors alive in 2020 is more than ten times the estimated annual tuberculosis incidence. Interventions to alleviate respiratory morbidity, screen for and prevent recurrent tuberculosis, and reduce stigma should be immediately prioritised for recently treated tuberculosis survivors. Full-Text PDF