Evaluating disability, comorbidities and risk factors after TB treatment: an 18–24 month follow-up

BACKGROUND: Several countries have developed national strategic plans to address post-TB disability and comorbidities. However, their feasibility and added value within routine programmatic settings remain undocumented. METHODS: We followed up individuals who successfully completed TB treatment at 11 health facilities in China between 2022-2023. Within the programmatic setting, we assessed health status, on-going symptoms, comorbidities, risk factors and disability (measured by 6-minute walking test [6MWT]) 18-24 months after treatment completion. RESULTS: Of 586 individuals who completed TB treatment, 503 (86%) were reassessed. Compared with end of TB treatment, there were significant increases in cough (11.0% versus 6.4%), untreated diabetes (3.2% versus <1.0%), high blood pressure (13.1% versus 8.9%), cigarette smoking (12.7% versus 5.2%) and excessive alcohol consumption (5.8% versus 1.2%). Other conditions remained similar with 27.0% still disabled (6MWT<400m). 78 (13%) patients died or were lost-to-follow-up, with risk factors at end of treatment including on-going symptoms (RR1.7, 95%CI 1.1-2.7), high blood pressure (RR2.3, 95%CI 1.2-4.1) and undernutrition (RR2.6, 95%CI 1.7-3.9). Nine patients had recurrent TB. Employment status remained unchanged, with 47.5% still unemployed 18-24 months later. CONCLUSIONS: TB survivors experienced substantial multimorbidity 18-24 months post-TB treatment. Health services must integrate long-term care strategies to address these ongoing health challenges.