title: Clinical significance of low forced expiratory flow between 25% and 75% of vital capacity following treated pulmonary tuberculosis: a cross-sectional study.
abstract: OBJECTIVE
  The aim of this study was to assess the prevalence and determinants of post-tuberculosis chronic respiratory signs, as well as the clinical impact of a low forced expiratory flow between 25% and 75% (FEF25-75%) in a group of individuals previously treated successfully for pulmonary tuberculosis.
  
  
  METHODS
  This was a cross-sectional study involving individuals in their post-tuberculosis treatment period. They all underwent a spirometry following the 2005 criteria of the American Thoracic Society/European Respiratory Society. Distal airflow obstruction (DAO) was defined by an FEF25-75% <65% and a ratio forced expiratory volume during the first second (FEV1)/forced vital capacity (FVC) ≥ 0.70. Logistic regression models were used to investigate the determinants of persisting respiratory symptoms following antituberculous treatment.
  
  
  METHODS
  This study was carried out in the tuberculosis diagnosis and treatment centre at Yaounde Jamot Hospital, which serves as a referral centre for tuberculosis and respiratory diseases for the capital city of Cameroon (Yaounde) and surrounding areas.
  
  
  METHODS
  All consecutive patients in their post-tuberculosis treatment period were consecutively enrolled between November 2012 and April 2013.
  
  
  RESULTS
  Of the 177 patients included, 101 (57.1%) were men, whose median age (25th-75th centiles) was 32 (24-45.5) years. At least one chronic respiratory sign was present in 110 (62.1%) participants and DAO was found in 67 (62.9%). Independent determinants of persisting respiratory signs were the duration of symptoms prior to tuberculosis diagnosis higher than 12 weeks (adjusted OR 2.91; 95% CI 1.12 to 7.60, p=0.029) and presence of DAO (2.22; 1.13 to 4.38, p=0.021).
  
  
  CONCLUSIONS
  FEF25-75%<65% is useful for the assessment and diagnosis of post-tuberculous DAO. Mass education targeting early diagnosis of pulmonary tuberculosis can potentially reduce the prevalence of post-tuberculosis respiratory signs and distal airflow obstruction.
authors: Faculty of Medicine and Biomedical Sciences, Department of Internal Medicine and Subspecialties, University of Yaounde I, Yaounde, Cameroon Pneumology Service, Yaounde Jamot Hospital, Yaounde, Cameroon.
authors: Eric Walter
authors: EW
authors: Pefura-Yone
authors: South African Medical Research Council and University of Cape Town, Cape Town, South Africa.
authors: Andre Pascal
authors: AP
authors: Kengne
authors: Faculty of Medicine and Biomedical Sciences, Department of Internal Medicine and Subspecialties, University of Yaounde I, Yaounde, Cameroon.
authors: Pierre Eugene
authors: PE
authors: Tagne-Kamdem
authors: Faculty of Medicine and Biomedical Sciences, Department of Internal Medicine and Subspecialties, University of Yaounde I, Yaounde, Cameroon Pneumology Service, Yaounde Jamot Hospital, Yaounde, Cameroon.
authors: Emmanuel
authors: E
authors: Afane-Ze
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012120:Respiration Disorders / Q000453:epidemiology* / Q000503:physiopathology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000503:physiopathology*; D014797:Vital Capacity; D055815:Young Adult