Multidimensional assessment of structural post-tuberculosis lung sequelae and respiratory health status in adults from northern Peru

Christian Alberto Rodriguez-Saldaña, Luis Gabriel Farfan-Chavez, Daniel Reyes-Chávez, Darwin Paul Ayala-Cespedes, Guiovanna Wong-Terrones, Mercedes del Pilar Barranzuela-Acosta, Jian Pierre Espinoza-Herreros, Ygnacio Yovani Moreno-Herrera, Gary Juan Ramos-Manchego, Elmer Córdova-Calle, Víctor Serna-Alarcón

Background Tuberculosis survivors often develop persistent respiratory sequelae, but data integrating structural abnormalities, functional impairment, symptoms, and respiratory health status from Latin America remain limited. Aim To assess structural post-tuberculosis lung sequelae and their association with respiratory health status in adults from northern Peru. Methods We conducted a prospective analytical cross-sectional study of 106 adults previously treated for pulmonary tuberculosis and evaluated at least 6 months after treatment completion. Structural sequelae were defined as fibrosis, bronchiectasis, or residual cavitary changes on non-contrast high-resolution chest CT. Dyspnea severity was assessed with the modified Medical Research Council scale and respiratory health status with the St George’s Respiratory Questionnaire. Associations were examined using robust Poisson, ordinal logistic, and linear regression models. Results Structural sequelae were present in 40.6% of participants, while multidimensional respiratory burden reached 59.4%. Older age was associated with structural sequelae (aPR 1.020, 95% CI 1.010–1.040), whereas longer time since treatment completion was inversely associated (aPR 0.950, 95% CI 0.920–0.980). Structural sequelae were associated with greater dyspnea severity (OR 7.680, 95% CI 3.110–20.120) and higher SGRQ scores ( β 11.410, 95% CI 6.200–16.610). Conclusion Structural post-tuberculosis lung sequelae were common and were associated with worse respiratory health status, supporting structured respiratory follow-up after treatment.