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Clinical significance of low forced expiratory flow between 25% and 75% of vital capacity following treated pulmonary tuberculosis: a cross-sectional study
  1. Eric Walter Pefura-Yone1,2,
  2. Andre Pascal Kengne3,
  3. Pierre Eugene Tagne-Kamdem1,
  4. Emmanuel Afane-Ze1,2
  1. 1Faculty of Medicine and Biomedical Sciences, Department of Internal Medicine and Subspecialties, University of Yaounde I, Yaounde, Cameroon
  2. 2Pneumology Service, Yaounde Jamot Hospital, Yaounde, Cameroon
  3. 3South African Medical Research Council and University of Cape Town, Cape Town, South Africa
  1. Correspondence to Dr Eric Walter Pefura-Yone; pefura2002{at}yahoo.fr

Abstract

Objectives The aim of this study was to assess the prevalence and determinants of post-tuberculosis chronic respiratory signs, as well as the clinical impact of a low forced expiratory flow between 25% and 75% (FEF25–75%) in a group of individuals previously treated successfully for pulmonary tuberculosis.

Design This was a cross-sectional study involving individuals in their post-tuberculosis treatment period. They all underwent a spirometry following the 2005 criteria of the American Thoracic Society/European Respiratory Society. Distal airflow obstruction (DAO) was defined by an FEF25–75% <65% and a ratio forced expiratory volume during the first second (FEV1)/forced vital capacity (FVC) ≥ 0.70. Logistic regression models were used to investigate the determinants of persisting respiratory symptoms following antituberculous treatment.

Setting This study was carried out in the tuberculosis diagnosis and treatment centre at Yaounde Jamot Hospital, which serves as a referral centre for tuberculosis and respiratory diseases for the capital city of Cameroon (Yaounde) and surrounding areas.

Participants All consecutive patients in their post-tuberculosis treatment period were consecutively enrolled between November 2012 and April 2013.

Results Of the 177 patients included, 101 (57.1%) were men, whose median age (25th-75th centiles) was 32 (24–45.5) years. At least one chronic respiratory sign was present in 110 (62.1%) participants and DAO was found in 67 (62.9%). Independent determinants of persisting respiratory signs were the duration of symptoms prior to tuberculosis diagnosis higher than 12 weeks (adjusted OR 2.91; 95% CI 1.12 to 7.60, p=0.029) and presence of DAO (2.22; 1.13 to 4.38, p=0.021).

Conclusions FEF25–75%<65% is useful for the assessment and diagnosis of post-tuberculous DAO. Mass education targeting early diagnosis of pulmonary tuberculosis can potentially reduce the prevalence of post-tuberculosis respiratory signs and distal airflow obstruction.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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