To study the burden of post tubercular obstructive airway diseases in patients visiting chest OPD at a tertiary level chest OPD in North India: a descriptive cross-sectional study

Abstract COPD and tuberculosis are on the rise in developing countries. There is evidence of post-tuberculosis lung function deterioration and the occurrence of obstructive airway diseases in such patient groups.

Objectives: To study the burden and severity of obstructive airway disease in subjects with a history of pulmonary tuberculosis and find the demographic trends, features, and clinical presentations in tuberculosis-associated obstructive pulmonary disease (TOPD) and non-tubercular obstructive airway disease (non-tubercular OAD).

Methodology: We investigated 125 patients divided into two groups, i.e., post-tubercular airway disease (n = 50) and airway disease due to other aetiology (n = 75). Age, gender, and BMI were analysed. Dyspnea grade was analysed using the Modified Medical Research Council (m MRC) scale. Spirometry was performed to find the pattern of airway disease in both groups. The severity of obstruction and lung functions were analysed using GOLD guidelines and spirometry.

Results: The males accounted for 71.2%, and females –28.8% of the patients. There were more females in the tubercular airway disease group. The mean age of the tubercular group (46.94 ± 14.67) was significantly lower than that of the non-tubercular airway disease (58.47 ± 6.14). No significant difference was found for BMI. Obstructive airway disease was more common in both groups (46% and 49.30%, respectively), and the severity of obstruction was higher in the TOPD group. The severity of cough and dyspnea was higher in that group. FVC and FEV1 were significantly reduced in TOPD compared to non-tubercular obstructive airway disease (non-tubercular OAD). The mean latency of COPD symptoms after completion of ATT was found to be 5.38 ± 6.77 years.

Conclusion: Post-tuberculosis subjects presented with lung function decline without confounding factors like smoking; thus, early screening of COPD is required once diagnosed; appropriate treatment should be initiated as early detection and treatment of these patients can help in better disease management and optimum treatment outcomes.