Post-Tuberculosis Lung Disease as a Hidden Burden: Implications for Long-Term Care and Primary Health Services – A Literature Review

Post-tuberculosis lung disease (PTLD) is becoming acknowledged as a significant long-term outcome of tuberculosis (TB), resulting from enduring structural and functional lung impairment despite successful microbiological treatment. This literature review consolidates existing evidence regarding the definitions and clinical spectrum of PTLD, its functional and socioeconomic impact, principal risk factors, post-TB treatment follow-up strategies, and available interventions, with a specific focus on their applicability to primary care environments. Research from cohort studies, meta-analyses, and policy reviews consistently indicates that around fifty percent of tuberculosis survivors suffer from chronic respiratory impairment, which may manifest as obstructive, restrictive, or mixed lung dysfunction patterns, along with enduring symptoms, decreased exercise capacity, lower quality of life, and reduced productivity. Key predictors of PTLD are delayed tuberculosis diagnosis, severe or bilateral illness, drug-resistant tuberculosis, host-related variables such as diabetes, malnutrition, and smoking, along with deficiencies in post-treatment follow-up within healthcare systems. Despite the potential of pulmonary rehabilitation and organized post-TB follow-up to enhance functional outcomes and quality of life, its implementation is still restricted and inconsistent, especially in high-burden, resource-limited environments. This review emphasizes a significant disparity between microbiological cure and long-term functional recovery, highlighting the necessity of incorporating PTLD screening, functional evaluation, and rehabilitative services into standard post-TB care at the primary care level to mitigate long-term disability and enhance the continuum of TB care.