Respiratory Health and Wellbeing Post Pulmonary Tuberculosis

Plain-language summary

We know that in low-income countries where there is a lot of tuberculosis (TB) about 20%-50% of people treated for TB have long term problems with their lungs and general wellbeing. This means they can't always get back to doing activities they were doing before they had TB and may need further treatment, for example antibiotics, inhalers or special rehabilitation classes. Some people are unnecessarily treated again for TB because they still have a cough. There have been two international guides published recently, describing standards for providing follow up care for people treated for TB. However, in the UK despite there being 4000 new cases of TB diagnosed every year, we do not follow these guidelines and we do not know if people treated for TB here have similar residual problems with their lungs and general wellbeing. It is difficult to advocate for people treated for TB to have follow up care if we do not know the size of the problem. Anecdotally, experts who do the clinics report that there are a large percentage of people who go on to have long term health problems after they are "cured" from TB but there is no pathway to follow them up. There are no UK guidelines or funding to support TB follow-up or ongoing treatment. It is possible, extrapolating from the data from other countries, that 2000 people a year in UK have undiagnosed or untreated lung health problems because of their previous TB. We would like to see if people who are treated in the Liverpool TB service (a regional referral service) have long term problems with their lungs. We will do this by inviting people who were treated for TB to come for a review at approximately 1 year after finishing their treatment. We will ask them to blow into a lung function testing machine (the same that is used for diagnosing asthma) and ask them questions about their health and wellbeing. If they have cough, we will ask them for a sputum sample, and we will collect a blood sample if people are willing to donate a small amount of blood to be used in future research. These will be stored in a special freezer for future related studies into biomarkers and mechanisms of disease. We will also invite some people to partake in recorded interviews where they can give their opinion about how they feel having been treated for TB and what (if any) follow up they feel they would benefit from. We hope that by recording the problems (if any) the people treated for TB have, we will then be able to use this data to design a larger UK-wide study investigating the prevalence of lung disease after treatment for TB. If we find that there is significant disease, in future we can then test treatment options and care pathways, as well as advocate for people to have improved follow up rather than just living with chronic lung health issues that might impair how well they can live their lives.

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