| dc.description.abstract | Introduction: As of 2021, there were around 10.6 million incident cases of tuberculosis (TB) worldwide, listing it as the leading cause of infectious-related death worldwide. Despite receiving a microbiological cure, approximately 50% of TB survivors experience mild to severe permanent lung impairment. Post-Tb lung disease (PTLD) can be complicated by infections of which the most severe is chronic pulmonary aspergillosis (CPA) that is a worry for many TB survivors worldwide, including the nearly 50,000 persons registered in 2021 in Uganda. The misdiagnosis of CPA as relapsing TB and the limited priority public health action, portrays that its gross mortality and morbidity are underrecognized. Moreso, the limited number of studies exploring its burden and associated factors cannot inform and sustain public health policies locally and globally.
Objective: This study sought to determine the prevalence and factors associated with CPA among PTLD patients at Makerere University Lung Institute (MLI).
Methods: This was a cross-sectional study that used the medical records of 219 patients with PTLD diagnosis at MLI from January 2018 to April 2023. The records were selected by consecutive sampling. The dependent variable was presence of CPA and the independent variables were socio-demographic and clinical characteristics. The data was entered into Epidata and exported to STATA for analysis. The association between the dependent variable and the independent variables was assessed using modified Poisson.
Results: The prevalence of CPA was 33.8% (CI: 27.6-40.5), was higher in those aged between 45 and 60 years (42.4%, CI: 30.3-55.2) and spread throughout the duration from TB treatment: <5 years 35.7% (CI: 25.55-46.92) 5-10years 40.0% (CI: 25.70-55.67) and >10years 28.9% (CI: 19.82-39.40). Nonprofessional work (PR-1.74 CI: 1.21-2.50), Multiple TB episodes (PR-1.97, CI: 1.37-2.84), HIV (PR-0.5, CI: 0.3-0.84), bronchiectasis (PR-1.96, CI: 1.42-2.72), cavities (PR-1.96, CI: 1.3-2.95) and unilateral lung damage (PR-2.05, CI: 1.30-3.24) were significantly associated with CPA.
Conclusion: This study showed that nearly four in every ten PTLD patients had CPA, with potential for manifestation any time after TB treatment, even beyond a decade later. CPA presentation implies pre-existing lung damage suggesting that the lung damage in PTLD patients could be chronic/permanent making them at risk of CPA throughout their life. Most CPA patients were below 60 years highlighting concerning consequences for their productivity, health related quality of life and overall development. Routine follow up of PTLD patients for CPA screening is highly recommended with specific emphasis on those with cavities, bronchiectasis, HIV and nonprofessional workers such as industrial workers, famers. | en_US |
