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A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease

BACKGROUND: Tuberculosis is an important risk factor for chronic respiratory disease in resource poor settings. The persistence of abnormal spirometry and symptoms after treatment are well described, but the structural abnormalities underlying these changes remain poorly defined, limiting our abilit...

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Autores principales: Meghji, Jamilah, Simpson, Hope, Squire, S. Bertel, Mortimer, Kevin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982669/
https://www.ncbi.nlm.nih.gov/pubmed/27518438
http://dx.doi.org/10.1371/journal.pone.0161176
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author Meghji, Jamilah
Simpson, Hope
Squire, S. Bertel
Mortimer, Kevin
author_facet Meghji, Jamilah
Simpson, Hope
Squire, S. Bertel
Mortimer, Kevin
author_sort Meghji, Jamilah
collection PubMed
description BACKGROUND: Tuberculosis is an important risk factor for chronic respiratory disease in resource poor settings. The persistence of abnormal spirometry and symptoms after treatment are well described, but the structural abnormalities underlying these changes remain poorly defined, limiting our ability to phenotype post-TB lung disease in to meaningful categories for clinical management, prognostication, and ongoing research. The relationship between post-TB lung damage and patient-centred outcomes including functional impairment, respiratory symptoms, and health related quality of life also remains unclear. METHODS: We performed a systematic literature review to determine the prevalence and pattern of imaging-defined lung pathology in adults after medical treatment for pleural, miliary, or pulmonary TB disease. Data were collected on study characteristics, and the modality, timing, and findings of thoracic imaging. The proportion of studies relating imaging findings to spirometry results and patient morbidity was recorded. Study quality was assessed using a modified Newcastle-Ottowa score. (Prospero Registration number CRD42015027958) RESULTS: We identified 37 eligible studies. The principle features seen on CXR were cavitation (8.3–83.7%), bronchiectasis (4.3–11.2%), and fibrosis (25.0–70.4%), but prevalence was highly variable. CT imaging identified a wider range of residual abnormalities than CXR, including nodules (25.0–55.8%), consolidation (3.7–19.2%), and emphysema (15.0–45.0%). The prevalence of cavitation was generally lower (7.4–34.6%) and bronchiectasis higher (35.0–86.0%) on CT vs. CXR imaging. A paucity of prospective data, and data from HIV-infected adults and sub-Saharan Africa (sSA) was noted. Few studies related structural damage to physiological impairment, respiratory symptoms, or patient morbidity. CONCLUSIONS: Post-TB structural lung pathology is common. Prospective data are required to determine the evolution of this lung damage and its associated morbidity over time. Further data are required from HIV-infected groups and those living in sSA.
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spelling pubmed-49826692016-08-29 A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease Meghji, Jamilah Simpson, Hope Squire, S. Bertel Mortimer, Kevin PLoS One Research Article BACKGROUND: Tuberculosis is an important risk factor for chronic respiratory disease in resource poor settings. The persistence of abnormal spirometry and symptoms after treatment are well described, but the structural abnormalities underlying these changes remain poorly defined, limiting our ability to phenotype post-TB lung disease in to meaningful categories for clinical management, prognostication, and ongoing research. The relationship between post-TB lung damage and patient-centred outcomes including functional impairment, respiratory symptoms, and health related quality of life also remains unclear. METHODS: We performed a systematic literature review to determine the prevalence and pattern of imaging-defined lung pathology in adults after medical treatment for pleural, miliary, or pulmonary TB disease. Data were collected on study characteristics, and the modality, timing, and findings of thoracic imaging. The proportion of studies relating imaging findings to spirometry results and patient morbidity was recorded. Study quality was assessed using a modified Newcastle-Ottowa score. (Prospero Registration number CRD42015027958) RESULTS: We identified 37 eligible studies. The principle features seen on CXR were cavitation (8.3–83.7%), bronchiectasis (4.3–11.2%), and fibrosis (25.0–70.4%), but prevalence was highly variable. CT imaging identified a wider range of residual abnormalities than CXR, including nodules (25.0–55.8%), consolidation (3.7–19.2%), and emphysema (15.0–45.0%). The prevalence of cavitation was generally lower (7.4–34.6%) and bronchiectasis higher (35.0–86.0%) on CT vs. CXR imaging. A paucity of prospective data, and data from HIV-infected adults and sub-Saharan Africa (sSA) was noted. Few studies related structural damage to physiological impairment, respiratory symptoms, or patient morbidity. CONCLUSIONS: Post-TB structural lung pathology is common. Prospective data are required to determine the evolution of this lung damage and its associated morbidity over time. Further data are required from HIV-infected groups and those living in sSA. Public Library of Science 2016-08-12 /pmc/articles/PMC4982669/ /pubmed/27518438 http://dx.doi.org/10.1371/journal.pone.0161176 Text en © 2016 Meghji et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Meghji, Jamilah
Simpson, Hope
Squire, S. Bertel
Mortimer, Kevin
A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease
title A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease
title_full A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease
title_fullStr A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease
title_full_unstemmed A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease
title_short A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease
title_sort systematic review of the prevalence and pattern of imaging defined post-tb lung disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982669/
https://www.ncbi.nlm.nih.gov/pubmed/27518438
http://dx.doi.org/10.1371/journal.pone.0161176
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