Mbanje Cassandra, Kuhn Isla, Musakwa Nozipho, Calvi Marzia, Boccia Delia, Muhwa Jeremiah Chakaya, Mvusi Lindiwe, Jaramillo Ernesto, Evans Denise, Meghji Jamilah
Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Cambridge University Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
EClinicalMedicine. 2024 May 27;73:102646. doi: 10.1016/j.eclinm.2024.102646. eCollection 2024 Jul.
There is a growing body of data describing a high burden of respiratory morbidity amongst pulmonary TB patients and survivors, with up to half thought to experience residual respiratory symptoms, abnormal spirometry, or structural pathology after TB treatment completion. Many patients experiencing marked impacts on their lives and livelihoods. However, there remain no guidelines or evidence-based frameworks for integrated TB-respiratory care during or post TB treatment completion. In this scoping review, completed in collaboration with the WHO Global Tuberculosis Programme, we have identified a lack of primary data on the clinical efficacy, cost effectiveness or feasibility of six potential interventions for the prevention and management of TB-associated respiratory impairment and disability, with a lack of studies in children and adolescents. There is a need for robust interventional trials to improve the long-term respiratory outcomes of people affected by pulmonary TB disease, and to explore how these might be implemented within resource-limited settings.
越来越多的数据表明,肺结核患者及其幸存者的呼吸系统疾病负担很重,多达一半的人在完成结核病治疗后被认为仍有残留的呼吸道症状、肺功能测定异常或结构病变。许多患者的生活和生计受到了显著影响。然而,在结核病治疗期间或完成后,仍然没有关于结核病-呼吸综合护理的指南或循证框架。在这项与世界卫生组织全球结核病规划合作完成的范围审查中,我们发现缺乏关于六种预防和管理结核病相关呼吸功能损害和残疾的潜在干预措施的临床疗效、成本效益或可行性的原始数据,而且针对儿童和青少年的研究也很缺乏。有必要进行有力的干预试验,以改善肺结核病患者的长期呼吸结局,并探索如何在资源有限的环境中实施这些干预措施。