Background Despite tuberculosis (TB) being a curable disease, current guidelines fail to account for the long-term outcomes of post-tuberculosis lung disease—a cause of global morbidity despite successful completion of effective treatment. Our systematic review aimed to synthesise the available evidence on the lung function outcomes of childhood pulmonary tuberculosis (PTB).
Methods PubMed, ISI Web of Science, Cochrane Library and ProQuest databases were searched for English-only studies without time restriction (latest search date 22 March 2023). Inclusion criteria were (1) patients who had TB with pulmonary involvement at age ≤18 years; (2) pulmonary function tests (PFTs) performed on patients after treatment completion; and (3) observational studies, including cohort and cross-sectional studies. We adhered to the recommendations of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Results From 8040 records, 5 studies were included (involving n=567 children), with spirometry measures from 4 studies included in the meta-analyses. The effect sizes of childhood TB on forced expiratory volume in the first second and forced vital capacity z-scores were estimated to be −1.53 (95% CI −2.65, –0.41; p=0.007) and −1.93 (95% CI −3.35, –0.50; p=0.008), respectively.
Discussion The small number of included studies reflects this under-researched area, relative to the global burden of TB. Nevertheless, as childhood PTB impacts future lung function, PFTs (such as spirometry) should be considered a routine test when evaluating the long-term lung health of children beyond their completion of TB treatment.
PROSPERO registration number CRD42021250172.
- Respiratory Medicine
- Child Development
- Child Health
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Contributors YLL collected and analysed the data, and wrote and revised the manuscript; YLL accepts full responsibility for the finished work and/or the conduct of the study, had access to the data, and controlled the decision to publish. YLL is guarantor. AFT collected and analysed the data, and reviewed the manuscript. SY critically reviewed the data analysis and interpretation, and reviewed the manuscript. TWY conceptualised and designed the study, and provided supervision. AC conceptualised the study, critically reviewed the manuscript and provided supervision. CL reviewed the initial analysis, critically reviewed the manuscript and provided supervision.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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