title: Tuberculosis and chronic respiratory disease: a systematic review.
abstract: BACKGROUND
  Chronic respiratory disease causes substantial global morbidity and mortality. The contribution of pulmonary tuberculosis to the aetiology of chronic respiratory disease is rarely considered, but may be important in tuberculosis-endemic areas.
  
  
  METHODS
  We performed a systematic literature review to assess the association between a history of tuberculosis and the presence of chronic obstructive pulmonary disease (COPD) or chronic suppurative lung disease (bronchiectasis). Study quality was evaluated using the National Heart Lung and Blood Institute quality assessment tool. Meta-analysis was performed using the DerSimonian and Laird random effects model.
  
  
  RESULTS
  We identified 9 eligible studies for COPD and 2 for bronchiectasis. Overall, there was a significant association between a history of tuberculosis and the presence of COPD in adults aged over 40 years (pooled odds ratio 3.05 (95% confidence interval 2.42, 3.85). Among individual COPD studies the strongest associations were found in countries with a high incidence of tuberculosis, as well as among never smokers and younger people.
  
  
  CONCLUSIONS
  In tuberculosis endemic areas, tuberculosis is strongly associated with the presence of chronic respiratory disease in adults. Efforts to improve long-term lung health should be part of tuberculosis care.
authors: The University of Sydney, Australia; Socios En Salud Sucursal, Partners In Health, Lima, Perú; Centre for Research Excellence in Tuberculosis (TB-CRE), Sydney, Australia. Electronic address: abyrne@med.usyd.edu.au.
authors: Anthony L
authors: AL
authors: Byrne
authors: The University of Sydney, Australia; Centre for Research Excellence in Tuberculosis (TB-CRE), Sydney, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, Australia.
authors: Ben J
authors: BJ
authors: Marais
authors: Socios En Salud Sucursal, Partners In Health, Lima, Perú; Harvard Medical School, Boston, MA, United States of America.
authors: Carole D
authors: CD
authors: Mitnick
authors: Socios En Salud Sucursal, Partners In Health, Lima, Perú
authors: Leonid
authors: L
authors: Lecca
authors: The University of Sydney, Australia; Centre for Research Excellence in Tuberculosis (TB-CRE), Sydney, Australia; The Woolcock Institute of Medical Research, Sydney, Australia.
authors: Guy B
authors: GB
authors: Marks
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000150:complications / Q000453:epidemiology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult
keywords: Bronchiectasis; Chronic Obstructive Pulmonary Disease; Chronic Respiratory Disease; Systematic Review; Tuberculosis