Lung function and chest radiographic abnormalities among adults with post-tuberculosis lung disease

SUMMARY BACKGROUND Post-tuberculosis lung disease (PTLD) is an emerging public health concern. However, functional impairment and structural lung abnormalities remain poorly characterised in resource-limited settings. We assessed 6-minute walk distance (6MWD), lung function, and radiologic features among symptomatic adults. METHODS We conducted a cross-sectional study between March 2023 and November 2024 among adults previously treated for tuberculosis (TB) with persistent respiratory symptoms. Clinical, spirometry, 6MWD, and high-resolution computed tomography imaging data were collected at the University Teaching Hospital, Lusaka, Zambia. Multivariable logistic regression was used to identify factors associated with abnormal 6MWD and lung function deficits. RESULTS Of the 105 participants, median age was 45 years (interquartile range [IQR] 18–71), and 6MWD was 345 m (IQR 150–570). Aspergilloma-related damage (n = 40, 38.1%) was the most common radiologic abnormality. Spirometry-defined restrictive lung function pattern was the predominant spirometry pattern (n = 58, 55.2%). Abnormal 6MWD was independently associated with female sex (adjusted odds ratio [aOR] 6.99 [1.754, 27.83] compared to male sex) and breathlessness (aOR 4.62 [1.22, 17.51] compared to no breathlessness). CONCLUSION PTLD is associated with significant functional impairment and radiologic sequelae among symptomatic post-TB patients. Routine post-treatment evaluation and targeted interventions addressing long-term disability should be considered in TB programmes.