Compared to the general population, adults with a history of tuberculosis are at risk of chronic fixed airflow obstruction and poor respiratory-related quality of life, even despite successful tuberculosis treatment. No pediatric studies have examined post-tuberculosis lung sequelae, yet knowing whether residual lung problems occur in children and adolescents is important for optimizing patient management and improving public health. The proposed project will evaluate respiratory sequelae in adolescents who are successfully treated for pulmonary tuberculosis. This proposal will leverage the principal investigator’s currently funded study, which will recruit adolescents in Peru with recently diagnosed pulmonary tuberculosis and follow them to the end of treatment. This application proposes to extend follow-up to one year post-treatment, add a control group, and address the following aims:

1)     To compare fixed airflow obstruction and respiratory-related quality of life between 160 adolescent TB survivors and 160 matched healthy controls. Fixed airway obstruction will be measured using spirometry, the reference standard, and oscillometry, a novel test that may be more sensitive and easier to perform than spirometry. Quality of life will be assessed using St. George’s Respiratory Questionnaire. We hypothesize that TB survivors will have a higher rate of fixed airway obstruction and worse quality of life.

1a) To determine whether fixed airflow obstruction and quality of life change over time in adolescent TB survivors. We will compare these outcomes between the time of treatment completion, six months post-treatment, and one year post-treatment.

1b) To compare the test performance of spirometry against the reference standard of oscillometry.

2)  To use computed tomography to characterize pathologic lung findings among adolescent TB survivors with fixed airway obstruction. We hypothesize that bronchiectasis will be the predominant abnormality in this group.