Post-tuberculosis pulmonary health: a vital healthcare problem

The pulmonary tuberculosis sequelae are currently an urgent problem in global health. Outcomes of pulmonary tuberculosis include structural, functional, and infectious changes. Objective. To study the prevalence of the tuberculosis sequelae, as well as risk factors and clinical manifestations of active pulmonary tuberculosis that affect the development of the sequelae in TB patients who have completed treatment. Materials and methods. Russian and foreign databases eLibrary.ru, PubMed, and MedLine were searched for the period from 1992 to 2024 using the following keywords: «tuberculosis», «post-tuberculosis changes», «smoking», «risk factors», «bronchopulmonary diseases», «tuberculosis», «post-tuberculosis changes», «pulmonary health», and «functional lung disorders». Results. Post-tuberculosis disorders of the bronchopulmonary system caused by active tuberculosis can play a key role in impairing the pulmonary health of patients after the treatment. A wide range of tuberculosis clinical forms can cause post-tuberculosis changes, including infiltrative, disseminated, fibro-cavernous, and cirrhotic forms. The manifestations of active tuberculosis, causing post-tuberculosis changes, are very diverse and, according to various studies, occur in at least 40% of patients who recovered from tuberculosis within 5 years. Airflow restriction caused, among other things, by bronchial obstructive disorders is the most common tuberculosis sequela. Its prevalence is up to 30% in various populations and is associated with a decrease in lung ventilation. Conclusion. A high prevalence of pulmonary tuberculosis sequelae was found. The clinical manifestations of post-tuberculosis changes are very diverse and include persistent respiratory symptoms, impaired lung ventilation (broncho-obstructive and restrictive disorders), the development of bronchiectasis, and bronchial stenosis. Therefore, developing comprehensive approaches to reduce the risk of post-tuberculosis sequelae, along with programs for their prevention and treatment, is a relevant direction in pulmonary health prevention.