New research shows that people who recently completed tuberculosis treatment were more likely to have chronic health conditions and poorer quality of life, underscoring the need for care that extends beyond curing the infection.
By Bunmi Yekini
People who have recently undergone treatment for tuberculosis are carrying a heavy burden of often undiagnosed chronic health conditions, including impaired lung function, undernutrition and mental health problems, according to a new study in Zimbabwe.
The research, published on Sept. 1 in PLOS Global Public Health, found that 91% of participants with recent tuberculosis (TB) had at least one chronic condition, while nearly two-thirds had two or more.
Researchers compared 96 adults who had recently been treated for pulmonary TB with 285 members of the same households who had no history of the disease.
The study, conducted in Harare, offered participants an integrated health assessment that included screening for HIV, diabetes, hypertension, anaemia, poor nutrition, mental health conditions, memory difficulties, vision problems and impaired lung function.
After accounting for age and sex, people with recent TB were more than twice as likely as their household counterparts to have at least one chronic health condition.
They were also more likely to be underweight, have impaired lung function, report memory difficulties and live with HIV. Symptoms associated with mental health disorders were also more common among TB survivors, while their overall health-related quality of life was poorer, the researchers found.
The findings add to growing evidence that the health consequences of tuberculosis can persist long after patients complete treatment.
While post-TB care has largely focused on lasting damage to the lungs, researchers said the effects of the disease could extend much further, affecting people’s physical and mental health and potentially increasing the overall burden attributed to TB.
An estimated 155 million people worldwide were alive after surviving TB in 2020, with many living with long-term consequences of the disease, the study said.
The researchers said integrating broader health services into TB treatment programmes could help identify conditions that might otherwise go undiagnosed.
However, only 96 of the 229 people with TB who were contacted agreed to participate in the health assessment, with work and migration among the most common reasons for non-participation.
The low uptake suggests that offering health checks as a separate service after TB treatment may not be enough, the researchers said, arguing that screening for other health problems should instead be integrated into routine TB care.
The study has limitations. Because it was cross-sectional, researchers said it could not establish whether the chronic conditions were caused by TB or existed before the infection. The relatively low participation rate among people with recent TB could also have influenced the findings.
Still, the researchers said the results point to a need to rethink what recovery from tuberculosis means.
“Holistic approaches to treatment which identify and address these conditions are needed,” the study concluded, adding that the contribution of post-TB chronic illness should be considered when estimating the global health burden of the disease.