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Towards a “fourth 90”: A population-based analysis of post-tuberculosis pulmonary function testing in British Columbia, Canada, 1985–2015

C. Andrew Basham, Victoria J. Cook, James C. Johnston
European Respiratory Journal 2020 56: 2000384; DOI: 10.1183/13993003.00384-2020
C. Andrew Basham
1School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
2British Columbia Centre for Disease Control, Vancouver, BC, Canada
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  • For correspondence: umbashac@myumanitoba.ca
Victoria J. Cook
2British Columbia Centre for Disease Control, Vancouver, BC, Canada
3Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada
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James C. Johnston
1School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
2British Columbia Centre for Disease Control, Vancouver, BC, Canada
3Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada
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Extract

Mounting evidence of chronic obstructive and restrictive lung disease among respiratory tuberculosis (TB) patients after treatment [1–4] raises questions about current practice in terms of linkage to care once pharmacologic treatment for TB has stopped. A systematic review of post-TB COPD showed pooled odds ratio of 3.05 (95% CI 2.42–3.85) for people with a history of TB compared to non-TB controls [3]. Another review reported a range of proportions of TB patients with airflow obstruction post-TB of 0.18–0.87 [1]. The development of a “fourth 90”, in addition to the three objectives of the Stop TB Partnership's Global Plan to End TB, has been suggested: “Ensuring that 90% of all people successfully completing treatment for TB can have a good health-related quality of life” [5].

Abstract

Post-tuberculosis lung disease is a growing concern globally. In a Canadian sample, only 3% of respiratory TB cases underwent pulmonary function testing within 90 days of treatment end. Benchmarks for post-TB pulmonary function testing are needed. https://bit.ly/2WX3tVf

Footnotes

  • All inferences, opinions, and conclusions drawn in this manuscript are those of the authors, and do not reflect the opinions or policies of the data stewards.

  • Author contributions: C.A. Basham, V.J. Cook and J.C. Johnston designed the study. C.A. Basham conducted the data analysis and interpretation. C.A. Basham drafted the manuscript. J.C. Johnston and V.J. Cook provided critical review comments and additional intellectual content. All authors approved the final manuscript. We gratefully acknowledge the comments of Faiz Ahmad Khan on an earlier draft.

  • Conflict of interest: C.A. Basham reports grants from Canadian Institutes for Health Research, during the conduct of the study.

  • Conflict of interest: V.J. Cook has nothing to disclose.

  • Conflict of interest: J.C. Johnston reports grants from Canadian Institutes for Health Research and Michael Smith Foundation for Health Research, during the conduct of the study.

  • Support statement: This project was supported by Canadian Institutes for Health Research (CIHR) Project (PJT #153213), which funded data access. CAB is supported by CIHR (PJT #153213). JCJ is supported by the Michael Smith Foundation for Health Research (MSFHR) and CIHR (PJT #153213). Funding information for this article has been deposited with the Crossref Funder Registry.

  • Received February 21, 2020.
  • Accepted March 24, 2020.
  • Copyright ©ERS 2020
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Towards a “fourth 90”: A population-based analysis of post-tuberculosis pulmonary function testing in British Columbia, Canada, 1985–2015
C. Andrew Basham, Victoria J. Cook, James C. Johnston
European Respiratory Journal Aug 2020, 56 (2) 2000384; DOI: 10.1183/13993003.00384-2020

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Towards a “fourth 90”: A population-based analysis of post-tuberculosis pulmonary function testing in British Columbia, Canada, 1985–2015
C. Andrew Basham, Victoria J. Cook, James C. Johnston
European Respiratory Journal Aug 2020, 56 (2) 2000384; DOI: 10.1183/13993003.00384-2020
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