Abstract Rationale Clinical guidelines now recommend routine screening for post-tuberculosis lung disease (PTLD) using spirometry. We aimed to assess the feasibility of routine health workers conducting screening spirometry in a low-income country, as measured by the quality of the tests performed. Methods We conducted a cross-sectional study of PTLD screening among adults completing TB treatment at an urban primary health center in Kampala, Uganda. All adults completing TB treatment were referred for handheld spirometry (EasyOne Air, ndd Medical Technologies). Testing was performed on-site by trained routine healthcare workers, including clinical officers and nurses, using a standardized protocol that allowed up to eight maneuvers per test. Three research nurses with expertise in spirometry independently selected the three best maneuvers and assessed their quality (considering acceptability, repeatability, usability, and grade) to determine overall interpretability, in accordance with ATS/ERS 2019 guidelines. They also delivered regular verbal feedback to healthcare workers to support ongoing quality assurance. We summarized demographic and clinical results using medians, proportions, and nonparametric testing. Results Between May and July 2025, we conducted spirometry testing on 173 adults completing TB treatment. Median age was 38 years; 35% were women; and 35% were persons living with HIV. Out of 519 maneuvers, 278 (53%) met all acceptability criteria by ATS/ERS 2019 guidelines. The end of forced expiration (EOFE) criterion was the most frequently missed acceptability criterion, not met in 148/519 (29%) maneuvers (Figure 1). In contrast, the back-extrapolated volume (BEV) criterion was the least frequently missed, absent in only 73/519 (14%) maneuvers. The proportion of maneuvers failing acceptability criteria decreased over the study course. Overall, 122/173 (71%) spirometry tests yielded clinically interpretable results. Interpretability improved over time: 74/113 (65%) tests in month 1 provided an interpretation, compared to 25/37 (68%) in month 2, and 23/23 (100%) in month 3 (p 0.01, chi-squared test for trend). Conclusions Screening spirometry for PTLD by routine healthcare workers in Uganda was feasible and achieved high levels of interpretability over three months following implementation. This abstract is funded by: WHO STOP TB Partnership
Labar et al. (Fri,) studied this question.