Chiang Silvia S, Romanowski Kamila, Johnston James C, Petiquan Alexandre, Lisboa Bastos Mayara, Menzies Dick, Land Sierra A, Benedetti Andrea, Ahmad Khan Faiz, van der Zalm Marieke M, Campbell Jonathon R
Department of Pediatrics, Brown University, Providence, Rhode Island, USA.
Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA.
BMJ Open. 2025 Mar 24;15(3):e094118. doi: 10.1136/bmjopen-2024-094118.
Approximately 2% of the global population has survived tuberculosis (TB). Increasing evidence indicates that a significant proportion of pulmonary TB survivors develop TB-associated respiratory impairment and disability-commonly referred to as post-TB lung disease-marked by impaired respiratory function, persistent symptoms and activity limitations. However, the prevalence, risk factors and progression of TB-associated respiratory disability throughout the life course are not well understood. To address these gaps, we will undertake a systematic review and individual participant-level data meta-analysis (IPD-MA) focusing on TB-associated respiratory impairment and disability in children, adolescents and adults successfully treated for pulmonary TB.
We will systematically search MEDLINE, Embase, CENTRAL, Global Index Medicus and medRxiv for original studies investigating TB-associated respiratory impairment and disability in people of all ages who have completed treatment for microbiologically confirmed or clinically diagnosed pulmonary TB. Authors of eligible studies will be invited to contribute deidentified data and form a collaborative group. Primary outcomes will be (1) abnormal lung function based on spirometry parameters and (2) chronic respiratory symptoms. We will estimate the overall and subgroup-specific prevalence of each outcome through IPD-MA. Next, we will develop clinical prediction tools assessing the risk of future TB-associated respiratory impairment and disability. Finally, we will use stepwise hierarchical modelling to identify epidemiological determinants of respiratory impairment and disability.
This study has been approved by the ethics review boards at the Rhode Island Hospital (2138217-2) and the Research Institute of the McGill University Health Centre (2024-10345). Individual study authors will be required to obtain institutional approval prior to sharing data. Results will be disseminated through open-access, peer-reviewed publications and conference presentations.
CRD42024529906.
全球约2%的人口曾患结核病（TB）并存活下来。越来越多的证据表明，相当一部分肺结核幸存者会出现与结核病相关的呼吸功能损害和残疾，通常称为结核病后肺部疾病，其特征为呼吸功能受损、症状持续以及活动受限。然而，结核病相关呼吸残疾在整个生命过程中的患病率、风险因素和进展情况尚未得到充分了解。为填补这些空白，我们将进行一项系统评价和个体参与者水平的数据荟萃分析（IPD-MA），重点关注成功治疗肺结核的儿童、青少年和成人中与结核病相关的呼吸功能损害和残疾。
我们将系统检索MEDLINE、Embase、CENTRAL、全球医学索引和medRxiv，以查找针对已完成微生物学确诊或临床诊断肺结核治疗的各年龄段人群中与结核病相关的呼吸功能损害和残疾的原始研究。符合条件的研究作者将被邀请提供去识别化数据并组成一个合作小组。主要结局将为：（1）基于肺量计参数的肺功能异常；（2）慢性呼吸道症状。我们将通过IPD-MA估计每个结局的总体患病率和亚组特异性患病率。接下来，我们将开发临床预测工具，评估未来发生与结核病相关的呼吸功能损害和残疾的风险。最后，我们将使用逐步分层模型来确定呼吸功能损害和残疾的流行病学决定因素。
本研究已获得罗德岛医院（2138217-2）和麦吉尔大学健康中心研究所（2024-10345）伦理审查委员会的批准。各研究的作者在共享数据前需获得机构批准。研究结果将通过开放获取、同行评审的出版物和会议报告进行传播。
PROSPERO注册号：CRD42024529906。
