Pulmonary TB (PTB) increases the risk of chronic lung complications, which are associated with increased morbidity and mortality. We determined the prevalence and predictors of post-TB lung disease and persistent symptoms in a resource-limited setting.Adults who completed PTB treatment underwent spirometry and completed the St. George's Respiratory Questionnaire (SGRQ), a questionnaire that assesses quality of life on symptom, activity, and impact. We performed multivariate analyses to calculate the X-adjusted prevalence ratio (PRadj) of abnormal spirometry and identify associated risk factors.Among the 162 participants, 89 (54.9%) were male. The median age was 32 years, and 65 (40.1%) had HIV. Overall, 65 participants (40.1%) had abnormal lung function, with spirometric restriction seen in 29.0%, obstruction in 4.9%, and a mixed pattern in 6.2%. Smoking (PRadj 1.88, 95% CI 1.11-3.16; P = 0.02) and female sex (PRadj 1.81, 95% Cl 1.15-2.84; P = 0.01) were independent risk factors for abnormal lung function. The median SGRQ scores were higher in participants with cavitation (P < 0.001) or bilateral consolidation on initial chest X-ray (P = 0.01).Lung function abnormalities, particularly spirometric restriction, are common in patients completing PTB treatment. Female sex and smoking status were associated with lung function abnormalities; therefore, additional studies to understand the underlying mechanistic pathways are warranted..
OMNIgene·SPUTUM (OM-S) is a sample transport reagent designed to work with all tuberculosis diagnostics while eliminating the need for cold chain. OM-S-treated sputum samples were assayed in several tests after multiday holds. Raw sputa from 100 patients underwent direct smear microscopy, were manually split and assigned to the OM-S group [OM-S added at collection (no other processing required) and tested after 0- to 5-day holds at room temperature] or standard-of-care (SOC) group (NaOH/N-acetyl l-cysteine decontamination, all tested on day of collection). Concentrated smear microscopy, Lowenstein Jensen (LJ) culture, and mycobacteria growth indicator tube (MGIT) culture were performed. For patients with negative direct smear, a second sample was split, with SOC (raw sputum) and OM-S portions (sediment) tested in the Xpert MTB/RIF (Xpert) assay. OM-S group and SOC group results were strongly concordant on all four tests [range, 89% (MGIT)–97% (Xpert)]. OM-S MGIT, LJ, and Xpert tests were in statistical agreement with SOC MGIT as reference. OM-S specimens had lower culture contamination rates (3% vs. 10% LJ; 2% vs. 5% MGIT) but required, on average, 5.6 additional days to become MGIT-positive. The findings suggest that samples held/transported in OM-S are compatible with smear microscopy, LJ or MGIT culture, and Xpert, and perform comparably to fresh sputum samples. Larger feasibility studies are warranted.