Post-tuberculosis sequelae and their correlation with quality of life: An observational study at a tertiary care center of north India

Abstract

ABSTRACTBackgroundLung impairment is a frequently recognised outcome in patients treated for pulmonary tuberculosis (TB). The impact of post-TB sequelae is not only restricted to clinical outcomes but also includes the quality of life and psycho-social well-being. However the magnitude of involvement of quality of life and the likely factors determining it are not clear. In this study, we assess the degree of compromise of quality of life and its determinants in patients of post-TB sequelae.MethodsPatients >18 years of age with a history of pulmonary tuberculosis were included in the study. Clinical history, pulmonary function test (PFT) and chest radiographs were recorded. The severity of dyspnea was evaluated using mMRC; quality of life assessment (QoL) was done using two standardized questionnaires- St. George’s Respiratory Questionnaire (SGRQ) and Seattle Obstructive Lung Disease Questionnaire (SOLQ).ResultsA total of 90 participants (mean age 40.4±11.6 years; 60 [66.7%] males) were recruited in the study. Overall, 93.3% (95% CI: 86.1%-97.5%) were currently symptomatic. A total of 96.8% (61/63) patients had abnormal pulmonary function test results, out of which 61.9% (39/63) had a mixed type. Out of 65 patients with chest radiographs available, 60 (92.3%,95% CI:84.6-96.8) patients had abnormalities with 45 (69.2%,95% CI: 58.3-78.2) having bilateral chest radiographic abnormalities. On assessment of QoL by SGRQ, the average score obtained was 42.3±24.0 (95% CI:37.3-47.3), with ‘Symptoms’ being the most affected domain. On using SOLQ, ‘Treatment satisfaction’ (mean score 38.5±21.7, 95% CI:34-43) and ‘Physical function’ (mean score 66.6±23.7, 95% CI:61.6-71.6) were the most affected. Neither spirometry results nor chest radiograph severity score could significantly account for the reduction of QoL. There was also a significant correlation between most of the parameters of SGRQ and SOLQ questionnaires in these patients.ConclusionPersistent respiratory symptoms, radiographic and spirometric abnormalities, were present in most of the patients with post-tubercular sequelae. Quality of life, as measured by SGRQ and SOLQ, was found to be significantly impaired in the majority of patients.