Public health action · 2026
Cured but not healed: high burden of pulmonary disability and multimorbidity among TB survivors in India.
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Subramanian S, Thekkur P, Chinnakali P, Tripathy J P, Ramaswamy G, Venugopal V, Sehgal I S, Soundappan K, Naik P, Nair D, Malegaonkar S, Babu V M, Jothula K Y, Malik A, Devaraj L, Rajaram M, Sarkar S, Harries A D, Zachariah R
Аннотация
SETTING: Five districts across five states of India.
OBJECTIVE: To assess the prevalence of TB-associated disability, comorbidities, risk determinants, and linkage to care among adults completing TB treatment between October 2024 and December 2025.
DESIGN: A cohort study using primary data collection. Trained research staff conducted all the assessments. Pulmonary disability meant impaired lung function on spirometry and/or walking <400 m on 6-minute walk test. Linkage to care was assessed through telephonic follow-up after a month of referral.
RESULTS: Of 780 participants, 85% had at least one comorbidity, risk determinant, or disability (multimorbidity). The prevalence of pulmonary disability was 60% (95% confidence interval: 56-64). Undernutrition (36%), diabetes (24%), and hypertension (19%) were the most common comorbidities, with 13% of diabetes and 55% of hypertension being newly detected. Pulmonary disability was associated with older age, pulmonary TB, undernutrition, mental health disorder, smoking, and silica exposure. Referral ranged from 12% to 100% for various conditions, with low rates for mental health disorders (12%) and recreational drug use (33%).
CONCLUSION: Successful completion of TB treatment and bacteriological cure does not imply restoration of health-related quality of life. Early integration of patient-centred care for multimorbidity is essential for restoring health among TB survivors.
OBJECTIVE: To assess the prevalence of TB-associated disability, comorbidities, risk determinants, and linkage to care among adults completing TB treatment between October 2024 and December 2025.
DESIGN: A cohort study using primary data collection. Trained research staff conducted all the assessments. Pulmonary disability meant impaired lung function on spirometry and/or walking <400 m on 6-minute walk test. Linkage to care was assessed through telephonic follow-up after a month of referral.
RESULTS: Of 780 participants, 85% had at least one comorbidity, risk determinant, or disability (multimorbidity). The prevalence of pulmonary disability was 60% (95% confidence interval: 56-64). Undernutrition (36%), diabetes (24%), and hypertension (19%) were the most common comorbidities, with 13% of diabetes and 55% of hypertension being newly detected. Pulmonary disability was associated with older age, pulmonary TB, undernutrition, mental health disorder, smoking, and silica exposure. Referral ranged from 12% to 100% for various conditions, with low rates for mental health disorders (12%) and recreational drug use (33%).
CONCLUSION: Successful completion of TB treatment and bacteriological cure does not imply restoration of health-related quality of life. Early integration of patient-centred care for multimorbidity is essential for restoring health among TB survivors.