Post Tb Pulmonary Disability: An Ongoing Challenge for India

Abstract

Introduction: Pulmonary tuberculosis can involve the airways, resulting in mucosal oedema, hypertrophy/hyperplasia of the mucosal glands, increased mucous secretion and smooth muscle hypertrophy. They affect the calibre of the airways, increase their resistance and decrease airflow. This study was planned to assess pulmonary disability by simple methods in symptomatic patients who were pulmonary tuberculosis survivors after successful treatment completion. Methodology: The present study was a cross sectional study, conducted at the Department of Respiratory Medicine, Pramukhswami Medical College, Karamasd, Anand. Total 53 patients fulfilling the criteria were included in the study. All patients underwent thorough clinical assessment, six minute walk test (6MWT), and spirometry for assessment of pulmonary disability. Spirometry was done after holding bronchodilators for 24 hours. In spirometry, pre-bronchodilator FVC, FEV1, FEV1/FVC and post bronchodilator FVC, FEV1, FEV1/FVC were the chief variables analyzed. Result: Out of total 53 patients, mean age of patients was 53.6 years. Maximum number of patients (14) (26.4%) were in the age group of 61-70 years. 42 (79.2%) were males and 11 (20.8%) were females. As per the WHO classification for BMI, 25 (47.2%) patients were underweight, 24 (45.3%) were in normal range and 4 (7.5%) were overweight. Spirometry pattern was normal in 3 patients, obstructive in 5 patients, restrictive in 20 (37.7%) patients and combined (mixed) in 25 (47.2%) patients. There was significant statistical difference between groups (spiometry pattern distribution) in context of mean weight. (P=< 0.001). According to the newly developed index, 2 (3.8%) patients belonged to class I, 1 (1.9%) patient to class II, 8 (15.1%) patients to class III, 10 (18.9%) patients to class IV and 32 (60.4%) patients belonged to class V pulmonary disability.