Residual lung damage after completion of treatment for multidrug-resistant tuberculosis.
METHODS
Limpopo Province, South Africa.


OBJECTIVE
To assess the residual lung damage of patients who completed treatment for multidrug-resistant tuberculosis (MDR-TB).


METHODS
Chest radiograph and lung function tests were performed at the end of treatment. The radiographs were read by two independent observers who attributed a zonal score of between 0 and 18, depending on the extent of radiographic abnormalities (opacification or cavitation), counted the number of visible cavities and measured the diameter of the largest cavity.


RESULTS
The mean zonal score was 6.5. Cavitation was present in more than half of the patients. Of 33 patients, 31 (94%) had abnormal lung function tests. The median FEV1 was 63% and FVC was 57% of the predicted value. Restrictive and combined restrictive-obstructive lung function patterns were the predominant abnormalities.


CONCLUSIONS
Residual lung damage in MDR-TB patients who completed treatment is common and extensive. This may increase the risk of relapse of tuberculosis and reduce the quality of life and life expectancy of these patients. Additional efforts are warranted to diagnose MDR-TB early to reduce the extent of residual lung damage. Close follow-up of MDR-TB patients completing treatment will have to be ensured to detect relapses.
de Vallière
S
S
Division of Infectious Diseases, St Louis University Hospital, St Louis, Missouri 63110, USA. devalls@slu.edu
Barker
R D
RD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D003140:Communicable Disease Control / Q000379:methods; D004338:Drug Combinations; D005260:Female; D005540:Forced Expiratory Flow Rates / Q000502:physiology; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012129:Respiratory Function Tests; D013019:South Africa; D013147:Spirometry; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D014797:Vital Capacity / Q000502:physiology
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D004338:Drug Combinations