Pulmonary function and quality of life in patients with treated smear positive pulmonary tuberculosis at Riruta, Kangemi and Kibera tuberculosis Clinics in Nairobi
Abstract
Background: Pulmonary impairment following TB treatment has been described in selected
populations. No previous studies have evaluated the effects of treated pulmonary TB on lung
function and QOL in Kenya.
Methods: This was a cross sectional study conducted at Riruta, Kangemi and Kibera Health
Centres between May and June 2012. Patients with cured smear positive TB in the last 2 years
were assessed for their current health status using the St Georges Respiratory questionnaire
and pulmonary function using spirometry.
Results: Of 409 eligible patients, 183 (58% males) were enrolled. There were no significant
differences in the demographic profiles of the study subjects and non responders.
53 patients (29%) had pulmonary impairment, the commonest being restrictive defects in 42
patients (23%, 95% CI 16.8-29.1%), obstructive defects in 9 patients (5%, 95% CI 1.76-8.08%)
and combined defects in 2 patients (1%, 95% CI -0.4-2.61%). Patients with abnormal lung
function were younger {median age, 29 years (IQR, 22-36) vs 34 years (IQR, 27-39), p= 0.036},
more likely to be underweight (38% vs 9%, P= <0.005) and had a lower prevalence of HIV
(20.8% vs 37.7%, p=0.027). Low BMI was the only independent predictor of pulmonary function
abnormality (p=0.001). The median QOL total score from the SGRQ was 3.16 (IQR, 0 – 8.9)
signifying good QOL. There was no correlation between QOL and pulmonary function.
Conclusions: The commonest lung function abnormality post TB treatment was restrictive
defect. The QOL in this population was good. Body mass index was the only independent
predictor of abnormal pulmonary function.
Citation
A thesis submitted in partial fulfillment of the requirements for the degree of Master of Medicine in Internal Medicine of the University of NairobiPublisher
University of Nairobi School of Medicine