International research and guidelines on post-tuberculosis chronic lung disorders: a systematic scoping review.

Autor:	van Kampen SC; Clinical Trials and Population Studies Department, University of Plymouth, Plymouth, United Kingdom., Wanner A; Clinical Trials and Population Studies Department, University of Plymouth, Plymouth, United Kingdom., Edwards M; Clinical Trials and Population Studies Department, University of Plymouth, Plymouth, United Kingdom., Harries AD; Union Headquarters, International Union Against Tuberculosis and Lung Disease, Paris, France.; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom., Kirenga BJ; Department of Pulmonary Medicine and Lung Institute, Makerere University, Kampala, Uganda., Chakaya J; Union Headquarters, International Union Against Tuberculosis and Lung Disease, Paris, France.; Department of Medicine, Therapeutics, Dermatology and Psychiatry, Kenyatta University, Nairobi, Kenya., Jones R; Clinical Trials and Population Studies Department, University of Plymouth, Plymouth, United Kingdom.
Jazyk:	angličtina
Zdroj:	BMJ global health [BMJ Glob Health] 2018 Jul 23; Vol. 3 (4), pp. e000745. Date of Electronic Publication: 2018 Jul 23 (Print Publication: 2018).
DOI:	10.1136/bmjgh-2018-000745
Abstrakt:	Introduction: Pulmonary tuberculosis (TB) is an important risk factor for chronic respiratory disease due to residual lung damage. Yet, the WHO End TB strategy does not mention post-TB chronic lung disorders (PTBLDs) and programmatic interventions to address PTBLD are lacking. This study assessed the scope of current guidelines and evidence on PTBLD to inform policy and research action. Methods: A systematic literature search was conducted following Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Eight databases (TRIP, International Guideline Library, MEDLINE/PubMed, EMBASE, Web of Science, Global Health, Cochrane Library) were searched for records on PTBLD published between 1 January 1990 and 1 December 2017. Non-English records, case series, conference abstracts and letters to editors were excluded. Data were extracted and charted on publication year, location, PTBLD condition(s) and main study outcome. Results: A total of 212 guidelines and 3661 articles were retrieved. After screening, only three international TB guidelines mentioned TB sequelae, but none described how to identify or manage the condition. A total of 156 articles addressed PTBLD: 54 (35%) mentioned unspecified TB sequelae; 47 (30%) specific post-TB conditions including aspergillosis, bronchial stenosis or bronchiectasis; 52 (33%) post-TB obstructive disorders or lung function impairment; and 20 (13%) post-TB respiratory symptoms or chest X-ray abnormalities. The first two groups mostly assessed surgery or ventilation techniques for patient management, while the last two groups typically assessed prevalence or predictors of disease. Conclusion: This is the first review to provide a comprehensive overview of the current literature on PTBLD. The scope of evidence around the burden of PTBLD warrants inclusion and recognition of the problem in international TB guidelines. Research is now needed on early detection of PTBLD and patient management options that are suitable for high-burden TB countries. Competing Interests: Competing interests: None declared.
Databáze:	MEDLINE
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