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A six-month follow-up study to evaluate changes of pulmonary function test in Category I pulmonary tuberculosis treatment completed patient

Prashant J Patil, Sarika P Patil.




Abstract

Background: Tuberculosis (TB) is being a preventable and curable disease that it accounts the world-wide problem. India is one of the TB burden countries. Clinical manifestation of pulmonary TB leads pulmonary dysfunction with functional changes in the lung tissue. Treated patients are free from mycobacterium and considered cured, but the restoration of lungs function in these patients is also needed.

Aims and Objectives: This study plans to evaluate and compare the pulmonary function test (PFT) parameters immediately, 3 months and 6 months after the completion of TB treatment and assess its severity.

Materials and Methods: By convenient sampling, 118 voluntarily participated pulmonary TB-treated patients completing Category I regimen. PFT during three intervals after the completion of full course of antitubercular drugs was evaluated. Spirometry was done in sitting position according to the American Thoracic Society (ATS) recommendation and interpretation of the results was done.

Results: Male-to-female proportion of the pulmonary TB patients was 56.8% versus 43.2%, respectively, within 22-65 years. Maximum patients, that is, 39% were within 31-40-year-age group. Immediate after completion of the treatment, 7.6% had symptoms of exertion dyspnea which were not on follow-up visits. The percent predictive values of the PFT were marginally above the impairment values. There was statistically significant difference mean forced vital capacity (FVC) (P < 0.001), forced expiratory volume at one second/FVC ratio percentage (P < 0.01), peak expiratory flow rate (P < 0.05), and maximal voluntary ventilation (P < 0.01) at the three intervals. Pulmonary function results were normal in 89.8% of patients immediately after the completion of TB treatment, in 91.5% at 3 months and 88.1% at 6 months. Impaired pulmonary function values were in 10.2% of patients at immediate, 8.5% at 3 months, and 11.9% patients at 6 months after completion of TB treatment. The 6-month PFT findings in 6.8% had obstructive changes, 3.4% had restrictive, and 1.7% with mixed PFT changes.

Conclusion: There is the presence of pulmonary functional limitations in Category I TB-treated patients. Values for PFT were still lower in few patients even after completion of 6 months of treatment for Category I pulmonary TB.

Key words: Pulmonary Tuberculosis; Pulmonary Function Test; Category I Regimen; Spirometry; American Thoracic Society; Forced Expiratory Volume at One Second; Peak Expiratory Flow Rate; Forced Vital Capacity; Maximal Voluntary






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