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Post-tuberculosis lung disease: a comparison of Brazilian, Italian, and Mexican cohorts

Authors
  • Silva, Denise Rossato1, 2
  • Freitas, Alana Ambos1
  • Guimarães, Amanda Reis2
  • D’Ambrosio, Lia3
  • Centis, Rosella4
  • Muñoz-Torrico, Marcela5
  • Visca, Dina6, 7
  • Migliori, Giovanni Battista4
  • 1 . Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil.
  • 2 . Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil.
  • 3 . Public Health Consulting Group, Lugano, Switzerland.
  • 4 . Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia.
  • 5 . Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas - INER - Ciudad de México, México.
  • 6 . Divisione di Riabilitazione Polmonare, Istituti Clinici Scientifici Maugeri - IRCCS - Tradate, Italia.
  • 7 . Dipartimento di Medicina e Chirurgia, Malattie dell’Apparato Respiratorio, Scuola di Medicina, Università degli Studi dell’Insubria, Tradate, Italia.
Type
Published Article
Journal
Jornal Brasileiro de Pneumologia
Publisher
Sociedade Brasileira de Pneumologia e Tisiologia
Publication Date
Apr 30, 2022
Volume
48
Issue
2
Identifiers
DOI: 10.36416/1806-3756/e20210515
PMID: 35584466
PMCID: PMC9064651
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Objective: To evaluate lung function in a cohort of patients with a history of pulmonary tuberculosis in Brazil, as well as to evaluate the decline in lung function over time and compare it with that observed in similar cohorts in Mexico and Italy. Methods: The three cohorts were compared in terms of age, smoking status, pulmonary function test results, six-minute walk test results, and arterial blood gas results. In the Brazilian cohort, pulmonary function test results, six-minute walk test results, and arterial blood gas results right after the end of tuberculosis treatment were compared with those obtained at the end of the follow-up period. Results: The three cohorts were very different regarding pulmonary function test results. The most common ventilatory patterns in the Brazilian, Italian, and Mexican cohorts were an obstructive pattern, a mixed pattern, and a normal pattern (in 58 patients [50.9%], in 18 patients [41.9%], and in 26 patients [44.1%], respectively). Only 2 multidrug-resistant tuberculosis cases were included in the Brazilian cohort, whereas, in the Mexican cohort, 27 cases were included (45.8%). Mean PaO2 and mean SaO2 were lower in the Mexican cohort than in the Brazilian cohort (p < 0.0001 and p < 0.002 for PaO2 and SaO2, respectively). In the Brazilian cohort, almost all functional parameters deteriorated over time. Conclusions: This study reinforces the importance of early and effective treatment of drug-susceptible tuberculosis patients, because multidrug-resistant tuberculosis increases lung damage. When patients complete their tuberculosis treatment, they should be evaluated as early as possible, and, if post-tuberculosis lung disease is diagnosed, they should be managed and offered pulmonary rehabilitation because there is evidence that it is effective in these patients.

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