Sun Y, Lin Y, Golub J E, Shu W, Jiang J, Xu Q, Li Y, Sun W, Shi Y, Liao J, Nie C, Liang C, Zhang X, Liu H, Ma Y, Zachariah R, Berger S D, Thekkur P, Nair D, Satyanarayana S, Kumar A M V, Harries A D
Clinical Center on TB, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
IJTLD Open. 2025 May 12;2(5):299-305. doi: 10.5588/ijtldopen.25.0149. eCollection 2025 May.
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.
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.
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.
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.
一些国家已制定国家战略计划以应对结核病后残疾和合并症问题。然而，这些计划在常规项目环境中的可行性和附加价值仍未得到记录。
我们对2022年至2023年期间在中国11家医疗机构成功完成结核病治疗的个体进行了随访。在项目环境中，我们在治疗完成18至24个月后评估了健康状况、持续症状、合并症、风险因素和残疾情况（通过6分钟步行试验[6MWT]测量）。
在完成结核病治疗的586名个体中，503名（86%）接受了重新评估。与结核病治疗结束时相比，咳嗽（11.0%对6.4%）、未治疗的糖尿病（3.2%对<1.0%）、高血压（13.1%对8.9%）、吸烟（12.7%对5.2%）和过量饮酒（5.8%对1.2%）显著增加。其他情况保持相似，仍有27.0%的人残疾（6MWT<400米）。78名（13%）患者死亡或失访，治疗结束时的风险因素包括持续症状（RR1.7，95%CI 1.1-2.7）、高血压（RR2.3，95%CI 1.2-4.1）和营养不良（RR2.6，95%CI 1.7-3.9）。9名患者结核病复发。就业状况保持不变，18至24个月后仍有47.5%的人失业。
结核病幸存者在结核病治疗后18至24个月经历了大量的合并症。卫生服务必须整合长期护理策略以应对这些持续的健康挑战。
