High prevalence of persistent tuberculosis-related symptoms 6 months after treatment in pulmonary tuberculosis

BACKGROUND: The frequency and determinants of persistent symptoms after microbiological cure remain incompletely defined in pulmonary tuberculosis. We aimed to determine the prevalence of persistent tuberculosis-related symptoms 6 months after treatment initiation and identify associated predisposing factors. METHODS: We analysed data from the prospective observational cohort study, enrolling adults treated for pulmonary tuberculosis at three tertiary hospitals in Korea between 2016 and 2018. Demographic, clinical and radiographic data, and symptoms were assessed using a standardised symptom checklist at baseline and at 2-month and 6-month follow-up visits. Symptom persistence was defined as the presence of any tuberculosis-related symptom at the 6-month visit. Multivariable logistic regression analysis was conducted to identify factors associated with persistent symptoms. RESULTS: Among 354 participants (61% men, mean age of 58.5±19.4 years), symptom prevalence decreased from 80.2% at baseline to 25.1% at 6 months. Cough (14.4 %) and dyspnoea (7.6 %) were the most common persistent symptoms. Independent predictors of persistent symptoms included foreign nationality (adjusted OR (aOR) 5.586; 95% CI 1.618 to 19.28), chronic lung disease (aOR 5.034; 95% CI 1.995 to 13.26), presence of tuberculosis-related symptoms at 2 months (aOR 3.195; 95% CI 1.833 to 5.685) and bilateral infiltration on chest X-ray (aOR 1.933; 95% CI 1.018 to 3.650) in the multivariate analysis. CONCLUSIONS: A significant proportion of patients experience persistent tuberculosis-related symptoms even 6 months after treatment initiation. These findings highlight the need for ongoing clinical assessment and post-treatment care to address residual symptom burden following pulmonary tuberculosis.