Volume 6, Issue 6, November 2018, Page: 170-181
Prediction of Post-Tuberculosis Lung Function Impairment
Eric Walter Pefura-Yone, Department of Internal medicine, Faculty of Medicine and Biomedical Sciences, The University of Yaounde 1, Yaounde, Cameroon; Pneumology A Service, Yaounde Jamot Hospital, Yaounde, Cameroon
Adamou Dodo Balkissou, Faculty of Medicine and Biomedical Sciences of Garoua, University of Ngaoundéré, Garoua, Cameroon
Amadou Djenabou, Approved Treatment Center for HIV, Yaounde Jamot Hospital, Yaounde, Cameroon
Virginie Poka-Mayap, Pneumology A Service, Yaounde Jamot Hospital, Yaounde, Cameroon
Boniface Moifo, Department of Radiology and Medical Imaging, Faculty of Medicine and Biomedical Sciences, The University of Yaounde 1, Yaounde, Cameroon
Marie-Chantal Madjoumessi, Institut Supérieur de Technologie Médicale, Yaounde, Cameroon
Brenda Tanyi, Faculty of Medicine and Biomedical Sciences, The University of Yaounde 1, Yaounde, Cameroon
Christopher Kuaban, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
André Pascal Kengne, Medical Research Council, Cape Town, South Africa
Received: Dec. 9, 2018;       Accepted: Dec. 25, 2018;       Published: Jan. 18, 2019
DOI: 10.11648/j.ajim.20180606.14      View  46      Downloads  15
Objective: The aim of this study was to establish prediction equations for post-tuberculosis residual lung function in patients successfully treated for pulmonary tuberculosis (PTB). Methods: This study took place at the Yaounde Jamot Hospital of Yaounde (YJH) and used data from three cross-sectional studies conducted from January to July 2015 (7 months), December 2015 to May 2016 (6 months) and from January to May 2017 (5 months). Adults successful treated for bacteriologically proven pulmonary TB were included. Spirometric indices including forced expiratory volume in 1s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio were measured using standard methods. Predicted values were estimated using the reference spirometric equations of the Global Lung Initiative equations (GLI) 2012. General linear models were used to establish prediction equations of post-tuberculous residual lung function. Internal validation of the derived models used the bootstrap resampling procedures. A difference was considered significant if p < 5%. Results: In this study, 400 patients (53.5% men) were included. The median age (25th -75th percentiles) of men was 40 (31-50) years and that of women was 36(27.8-46) years (p=0.002). Determinants of the post-tuberculosis spirometric indices vary according to each indice and include age, weight, height, body mass index, smoking, duration of symptoms before TB treatment, persistent of respiratory symptoms after TB treatment, persistent of cavity lesions and extension of lung sequelae. The prediction equations of the spirometric indices have been established separately for men and women to account for significant differences in the absolute values of spirometric parameters in men and women. The prediction equations of residual lung function parameters were in the form: lung function parameters = Intercept + β1*P1 + β2*P2 +…βn*Pn; βn is regression coefficient for corresponding predictor (Pn), for categorical variables Pn is 1 if the modality is present and 0 if the modality is absent. For each of the spirometric variable, differences in performance measures (optimism) were mostly marginal. Conclusion: The equations developed and validated in this study could help the selection of patients in whom spirometry should be a priority after TB treatment. Like any newly developed model, results from this study are just preliminary findings. Models will require independent external validation to establish the performance both in the study setting and in other settings.
Tuberculosis, Residual Lung Function, Spirometry, Sequelae, Obstructive Lung Disease, Restrictive Pattern
To cite this article
Eric Walter Pefura-Yone, Adamou Dodo Balkissou, Amadou Djenabou, Virginie Poka-Mayap, Boniface Moifo, Marie-Chantal Madjoumessi, Brenda Tanyi, Christopher Kuaban, André Pascal Kengne, Prediction of Post-Tuberculosis Lung Function Impairment, American Journal of Internal Medicine. Vol. 6, No. 6, 2018, pp. 170-181. doi: 10.11648/j.ajim.20180606.14
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
World Health Organization. Global tuberculosis report 2016. WHO. 2017. http://apps.who.int/medicinedocs/en/d/Js23098en/. Accessed September 5, 2018.
World Health Organization. Global tuberculosis report 2018. WHO. 2018. http://www.who.int/tb/publications/global_report/en/. Accessed December 23, 2018.
WHO. Countries profile 2018. https://www.who.int/countries/cmr/en/. Accessed December 23, 2018.
Al-Hajjaj MS, Joharjy IA. Predictors of radiological sequelae of pulmonary tuberculosis. Acta Radiol. 2000;41:533–7.
N’dri K, Ake A AC, Konate I, Konan A, Chiedi AS, Abby B CB. Les aspects radiographiques des sequelles de la tuberculose pulmonaire. Med. Afr. Noire. 2006;53:704–8.
Ramos LMM, Sulmonett N, Ferreira CS, Henriques JF, de Miranda SS. Functional profile of patients with tuberculosis sequelae in a university hospital. J. Bras. Pneumol. 2006;32:43–7.
Ehrlich RI, Adams S, Baatjies R, Jeebhay MF. Chronic airflow obstruction and respiratory symptoms following tuberculosis: a review of South African studies. Int. J. Tuberc. Lung Dis. 2011;15:886–91.
Tchaou M , Sonhaye L, Kotosso A, Adjenou K, Agoda-Koussema L, N’Timon B, Amadou A, Djagnikpo O.. Aspects radiographiques des séquelles de la tuberculose chez les personnes vivant avec le VIH/SIDA à Lomé –Togo. J Fran Viet Pneu. 2012;3:28–31.
Jung CY, Jeon YJ, Rho BH. RAdiologic findings and lung function in patients with tuberculous destroyed lung. Chest. 2011;140:766A–766A.
Mbatchou Ngahane BH, Nouyep J, Nganda Motto M, Mapoure Njankouo Y, Wandji A, Endale M, et al. Post-tuberculous lung function impairment in a tuberculosis reference clinic in Cameroon. Respir. Med. 2016;114:67–71.
Ngahane BHM, Wandji A, Endalle M, Nouyeb J, Ze EA. Facteurs associés à la survenue d’anomalies ventilatoires post-tuberculeuses à Douala, Cameroun. Rev. Mal. Respir. 2015;32, Supple:A230.
Báez-Saldaña R, López-Arteaga Y, Bizarrón-Muro A, Ferreira-Guerrero E, Ferreyra-Reyes L, Delgado-Sánchez G, et al. A novel scoring system to measure radiographic abnormalities and related spirometric values in cured pulmonary tuberculosis. PLoS One. 2013;8:e78926.
Lee EJ, Lee SY, In KH, Yoo SH, Choi EJ, Oh YW, et al. Routine pulmonary function test can estimate the extent of tuberculous destroyed lung. ScientificWorld Journal. 2012;2012:835031.
Pasipanodya JG, Miller TL, Vecino M, Munguia G, Garmon R, Bae S, et al. Pulmonary impairment after tuberculosis. Chest. 2007;131:1817–24.
World Health Organisation. Treatment of tuberculosis guidelines. Geneva: WHO. 2009. Accessed September 5, 2018.
Austin PC, Steyerberg EW. The number of subjects per variable required in linear regression analyses. J. Clin. Epidemiol. 2015;68:627–36.
Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988;93:580–6.
Ralph AP, Ardian M, Wiguna A, Maguire GP, Becker NG, Drogumuller G, et al. A simple, valid, numerical score for grading chest x-ray severity in adult smear-positive pulmonary tuberculosis. Thorax. 2010;65:863–9.
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur. Respir. J. 2005;26:319–38.
Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur. Respir. J. 2012;40:1324–43.
Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur. Respir. J. 2005;26:948–68.
Stanojevic S, Wade A, Stocks J. Reference values for lung function: past, present and future. Eur. Respir. J. 2010;36:12–9.
Ratomaharo J, Linares Perdomo O, Collingridge DS, Andriamihaja R, Hegewald M, Jensen RL, et al. Spirometric reference values for Malagasy adults aged 18-73 years. Eur. Respir. J. 2015;45:1046–54.
Pefura-Yone EW, Kanko-Nguekam NF, Kengne AP, Balkissou AD, Kuaban C. Équations spirométriques de référence des Bantous camerounais. Rev. Mal. Respir.
Bougrida M, Ben Saad H, Kheireddinne Bourahli M, Bougmiza I, Mehdioui H. [Spirometric reference equations for Algerians aged 19 to 73 years]. Rev. Mal. Respir. 2008;25:577–90.
Hankinson JL, Odencrantz JR, Fedan KB. Spirometric Reference Values from a Sample of the General U. S. Population. Am. J. Respir. Crit. Care Med. 1999;159:179–87.
Vijayan VK. Chronic obstructive pulmonary disease. Indian J. Med. Res. 2013;137:251–69.
Arora S, Rasania S, Bachani D, Gandhi A, Chhabra S. Air pollution and environmental risk factors for altered lung function among adult women of an urban slum area of Delhi: A prevalence study. Lung India. 2018;35:193.
Pefura-Yone EW, Kuaban C, Assamba-Mpom SA, Moifo B, Kengne AP. Derivation, validation and comparative performance of a simplified chest X-ray score for assessing the severity and outcome of pulmonary tuberculosis. Clin. Respir. J. 2015;9:157–64.
Pefura-Yone EW, Kengne AP, Tagne-Kamdem PE, Afane-Ze E. Clinical significance of low forced expiratory flow between 25% and 75% of vital capacity following treated pulmonary tuberculosis: a cross-sectional study. BMJ Open. 2014;4:e005361.
Radovic M, Ristic L, Ciric Z, Dinic-Radovic V, Stankovic I, Pejcic T, et al. Changes in respiratory function impairment following the treatment of severe pulmonary tuberculosis - limitations for the underlying COPD detection. Int. J. Chron. Obstruct. Pulmon. Dis. 2016;11:1307–16.
Ravimohan S, Kornfeld H, Weissman D, Bisson GP. Tuberculosis and lung damage: from epidemiology to pathophysiology. Eur. Respir. Rev. 2018;27.
Harrell FE. Regression Modeling Strategies. 1995. Available from: http://biostat.mc.vanderbilt.edu/tmp/course.pdf. Accessed September 5, 2018.
Browse journals by subject