Lung problems persist in most adolescents even after TB treatment, according to researchers

South Africa is facing a significant challenge with tuberculosis Picture: Kristine Wook/Unsplash

South Africa is facing a significant challenge with tuberculosis Picture: Kristine Wook/Unsplash

Published Jan 18, 2024


South Africa is facing a significant challenge with tuberculosis (TB), particularly as it has the highest incidence rate of TB in Africa, representing approximately 301,000 cases annually.

This situation is exacerbated by the disease being one of the leading causes of death for individuals infected with HIV.

Factors contributing to the high prevalence of TB in South Africa and Africa as a whole include poverty, overcrowding, malnutrition, and cultural beliefs, resulting in infected individuals not seeking medical attention.

Additionally, the treatment of TB is hindered by the lengthy period of up to 6 months required for daily medication, which often leads to the risk of drug-resistant TB if medication is not taken correctly or if treatment is interrupted.

The need for effective treatment is crucial, not only for the individual's health but also to prevent the spread of TB within communities.

Early diagnosis, successful treatment and social support are essential factors in managing TB, pointing to the importance of continual diagnostics for treatment.

A recent study from Stellenbosch University has highlighted the impact of TB on the lung function of adolescents, especially after completing treatment.

The study revealed that two out of three adolescents diagnosed with pulmonary TB show lung abnormalities even after treatment completion, raising concerns about their long-term respiratory health.

In light of these findings, healthcare providers need to prioritise the treatment of teenagers with tuberculosis, as they face specific challenges due to being at a higher risk of contracting TB and potentially spreading it to others.

Furthermore, TB can lead to serious and long-lasting breathing problems in teenagers, highlighting the need for targeted research and treatment plans to address their specific needs and prevent the spread of the disease.

Dr Marieke van der Zalm, the lead researcher from Stellenbosch University's Desmond Tutu TB Centre, highlighted the significance of the study's findings, which were published in The Lancet's series, eClinicalMedicine.

This research is the first to fully evaluate how well teenagers' lungs work when they are being treated for TB and after their treatment is finished.

The study found that a lot of teenagers still have trouble with their lungs even after they finish treatment for TB. Dr Van der Zalm thinks it's important to find young people who might have lung problems after TB and to help their lungs get better after they are done with TB treatment.

The research looked at teens aged 10 to 19 in Cape Town, South Africa. It compared the lung health of 50 teens who had TB with 50 teens who were around TB but didn't get sick.

The study showed that 76% of the teens with TB had lung problems after two months of treatment.

Even after finishing treatment, about a year later, 65% of them still had lung problems.

Patients who have finished treatment for TB are still having trouble with their lungs, which is causing problems in their daily lives.

Some things they might feel after treatment include:

  • A continuous cough that remains stubborn despite the infection being cleared.
  • Difficulty in breathing, which translates to a struggle with previously manageable daily activities.
  • A noticeable decline in lung capacity indicates a reduced level of lung performance post-infection.
  • The development of scar tissue within the lungs, a direct consequence of TB adversely impacts respiratory function.
  • Incidents of shortness of breath, affect patients not only during physical exertion but potentially even while at rest.
  • An enhanced probability of recurring lung infections, with the lungs remaining more vulnerable due to damage sustained from TB.
  • The onset of bronchiectasis, characterised by the permanent expansion of portions of the lung's airways, further complicates a patient's health.

Van der Zalm highlighted the potential long-term implications, noting that lower lung function in adolescents with TB, even after successful treatment, may hinder their ability to reach their full lung potential as they reach adulthood.

The research suggests a subsequent risk of developing chronic lung disease early in life, underscoring the need to address potential long-term heart and lung problems in this population.

This study highlights the pressing necessity to involve adolescents in research focusing on preventing and treating TB-related respiratory issues.

The researchers have urged for lung health assessments to be incorporated as a vital aspect of TB treatment trials for adolescents, emphasising the critical need to prioritise the respiratory well-being of this vulnerable group.