Page, Kathleen

Medicine - Medicine

Pulmonary and functional status of patients after treatment for pulmonary tuberculosis

Mycobacterium tuberculosis (TB) represents the second largest infectious cause of death, with the developing world carrying a disproportionate burden of disease.1 The challenge of curbing the global TB epidemic is compounded by the recent proliferation of multidrug resistant (MDR) strains.2 Evidence suggests that pulmonary TB may cause long-term respiratory sequelae after patients are cleared of bacteriologic infection, especially among patients treated for MDR-TB.3 However, few longitudinal studies have been conducted to characterize long-term respiratory sequelae in TB patients and to compare outcomes between MDR versus drug-sensitive cases.   In addition, the biologic mechanism underlying the association between past TB infection and subsequent impairment of lung function has not been elucidated.  We hypothesize that pulmonary function and functional status decline at a greater rate among individuals previously treated for pulmonary TB compared to controls with no TB history and that this rate is greatest among participants previously treated for MDR-TB. Further, we hypothesize that these differences in rate of decline arise from prolonged low-grade local and systemic inflammation, the extent of which varies by disease status.  We propose a 2-year, longitudinal study of participants with and without history of TB in resource-poor, peri-urban sector of Lima, Peru.  Ultimately, we aim to characterize the relationship between history of TB and pulmonary and functional status, correlating longitudinal trends in lung function with biomarkers of inflammation. This work will allow us to obtain preliminary data for an R01 proposing a large, prospective cohort study to establish a causal relationship between TB and chronic lung disease.

Robert Gilman, SPH, International Health; William Checkley, Medicine

People

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs
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October 2017

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