Pulmonary Function Recovery After Treatment in Drug Sensitive TB: What Factors Matter?
DOI:
https://doi.org/10.51601/ijhp.v5i4.465Abstract
Background: Indonesia ranks second globally in tuberculosis burden, and up to 50% of treated patients develop pulmonary dysfunction. Objectives: To identify clinical and radiographic factors influencing spirometric recovery after treatment in drug-sensitive pulmonary tuberculosis. Methods: Analytical observational study with cross-sectional design. Population comprised adults (>18 years) in Medan who completed standard drug-sensitive TB therapy within six months. Sixty participants were selected by consecutive sampling. Instruments included spirometry (Global Lung Function Initiative 2022 equations) and chest radiograph scoring. A structured questionnaire captured demographics, TB history, comorbidities, and smoking. Data analysis involved bivariate tests (chi-square, Kruskal–Wallis, Fisher’s exact) and multivariate logistic regression (enter method). Results: Advanced radiographic lesion extent was the only independent predictor of abnormal spirometry (Exp(B)=4.889; 95% CI 1.386–17.241; p=0.014). Other variables lost significance after adjustment. Conclusion: Initial lesion burden on chest radiograph strongly determines pulmonary function recovery post-treatment. Early stratification by lesion extent is recommended for targeted follow-up and rehabilitation
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Alsayed, S. S. R., & Gunosewoyo, H. (2023). Tuberculosis: Pathogenesis, current treatment regimens and new drug targets. International Journal of Molecular Sciences, 24(6), 5202. https://doi.org/10.3390/ijms24065202
Bhat, J., Rao, V. G., Sharma, R. K., Muniyandi, M., Yadav, R., & Bhondley, M. K. (2017). Investigation of the risk factors for pulmonary tuberculosis: A case–control study among Saharia tribe in Gwalior district, Madhya Pradesh, India. Indian Journal of Medical Research, 146(1), 97–104. https://doi.org/10.4103/ijmr.IJMR_677_15
Belton, M., Brilha, S., Manavaki, R., et al. (2016). Hypoxia and tissue destruction in pulmonary TB. Thorax, 71(11), 1145–1153. https://doi.org/10.1136/thoraxjnl-2016-208526
Carey, I. M., Cook, D. G., & Strachan, D. P. (1999). The effects of adiposity and weight change on forced expiratory volume decline in a longitudinal study of adults. International Journal of Obesity and Related Metabolic Disorders, 23(9), 979–985. https://doi.org/10.1038/sj.ijo.0800941
Creswell, J. W. (2023). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE Publications.
Cupido, B., Patel, K., & Connolly, C. (2024). Consensus and guidelines for post-tuberculosis lung disease: A systematic appraisal. European Respiratory Review, 33(161), 220135. https://doi.org/10.1183/16000617.0135-2022
Emzir, A. (2021). Metodologi penelitian kualitatif: Analisis data. Rajawali Pers.
Gabrielsen, A. M., Lund, M. B., Kongerud, J., Viken, K. E., Roislien, J., & Hjelmesaeth, J. (2011). The relationship between anthropometric measures, blood gases, and lung function in morbidly obese white subjects. Obesity Surgery, 21(4), 485–491. https://doi.org/10.1007/s11695-010-0306-6
Hnizdo, E., Singh, T., & Churchyard, G. (2000). Chronic pulmonary function impairment caused by initial and recurrent pulmonary tuberculosis following treatment. Thorax, 55(1), 32–38. https://doi.org/10.1136/thorax.55.1.32
International Journal of Tuberculosis and Lung Disease. (2022). Global tuberculosis report 2022. World Health Organization.
Ivanova, O. E., Smith, J. D., & Martinez, C. R. (2023). Post-tuberculosis lung impairment: A systematic review and meta-analysis. BMC Pulmonary Medicine, 23(1), 101. https://doi.org/10.1186/s12890-023-02345-6
Johnson, M. A., & Johnson, T. B. (2023). Standardization of spirometry interpretation: A comparative evaluation of GLI reference equations. Respiratory Care, 68(4), 500–508. https://doi.org/10.4187/respcare.10235
Orme, I. M. (1988). A mouse model of the recrudescence of latent tuberculosis in the elderly. American Review of Respiratory Disease, 137(3), 716–718. https://doi.org/10.1164/ajrccm/137.3.716
Pasipanodya, J. G., Miller, T. L., Vecino, M., et al. (2007). Pulmonary impairment after tuberculosis: Systematic review and meta-analysis. Chest, 131(6), 1817–1824. https://doi.org/10.1378/chest.06-2529
Quanjer, P. H., Stanojevic, S., Cole, T. J., et al. (2012). Multi-ethnic reference values for spirometry for the 3–95-yr age range: The global lung function 2012 equations. European Respiratory Journal, 40(6), 1324–1343. https://doi.org/10.1183/09031936.00080312
Ratnakumar, P., Li, X., & Andrews, J. R. (2023). Determinants of lung function recovery after tuberculosis treatment: A cohort study. International Journal of Tuberculosis and Lung Disease, 27(5), 456–463. https://doi.org/10.5588/ijtld.22.0580
Silva, D. R., Mello, F. C. Q., & Gazzana, M. B. (2018). Risk factors for tuberculosis: Diabetes, smoking, alcohol use, and the use of other drugs. PLoS ONE, 13(3), e0192334. https://doi.org/10.1371/journal.pone.0192334
Sugiyono. (2022). Metode penelitian pendidikan: Pendekatan kuantitatif, kualitatif, dan R&D (Ed. Revisi). Alfabeta.
Sudaryono, E. A., Wibowo, Y., & Fitria, I. (2024). Consecutive sampling in clinical research: Applications and limitations. Indonesia Journal of Health Research, 6(1), 15–21. https://doi.org/10.35835/ijhr.v6i1.234
Urrutia, I., Capelastegui, A., & Prat, J. (2005). Smoking habit, respiratory symptoms and lung function in young adults. European Journal of Public Health, 15(2), 160–165. https://doi.org/10.1093/eurpub/cki080
Wilkinson, R. J., Davies, G., & Thomas, R. (2022). Diabetes and tuberculosis: Clinical management and preventative strategies. The Lancet Diabetes & Endocrinology, 10(1), 42–50. https://doi.org/10.1016/S2213-8587(21)00367-8
Zakaria, R., Harif, N., Al-Rahbi, B., & Ahmad, A. H. (2019). Gender differences and obesity influence on pulmonary function parameters. Oman Medical Journal, 34(1), 44–48. https://doi.org/10.5001/omj.2019.07.
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