Abstract Rationale Post-tuberculosis lung disease (PT-LD) is increasingly recognized as a major cause of long-term respiratory disability, yet its burden and determinants remain underexplored in India. Many patients experience chronic airflow limitation or restrictive defects even after successful TB treatment, often worsened by smoking and biomass fuel exposure. This study addresses the need to characterize pulmonary function patterns among post-TB patients across rural and urban populations. We hypothesized that environmental and lifestyle factors, particularly smoking and biomass exposure, significantly influence the type and severity of ventilatory impairment in PT-LD patients. Methods This observational, comparative study was conducted in the Department of Pulmonary Medicine, SRN Hospital, MLN Medical College, Allahabad, Prayagraj, India. Patients aged 18-65 years with a history of adequately treated pulmonary TB who presented with respiratory complaints were included. Spirometry was performed before and 15 minutes after salbutamol inhalation. Patients were grouped as urban and rural, smoker and non-smoker, and results were analyzed according to smoking status and biomass fuel exposure in PT-LD patients. Statistical tests included Student’s t-test and Chi-square, with p 0.05 considered significant. Results A total of 600 post-tuberculosis lung disease (PTLD) patients were evaluated — 215 from urban areas and 385 from rural areas in and around Allahabad district. Based on spirometric evaluation: Obstructive ventilatory defect was the most common pattern, observed in 312 patients (52%), Restrictive defect in 192 patients (32%), and Mixed ventilatory pattern in 96 patients (16%). Rural patients exhibited a higher prevalence of restrictive and mixed patterns, suggesting greater parenchymal fibrosis, while urban patients, particularly smokers, showed predominantly obstructive changes with reduced FEV1/FVC ratios and limited bronchodilator response. Smokers demonstrated significantly lower FEV1 and FVC values than non-smokers, whereas biomass fuel exposure further contributed to lung function decline in rural populations. Non-smokers, especially from rural areas, displayed better bronchodilator reversibility, indicating a partially reversible component. Conclusion Post-tuberculosis lung disease remains a major cause of chronic respiratory impairment despite successful TB treatment. In this study, urban patients, especially smokers, showed more severe airflow obstruction and poor bronchodilator response, whereas rural patients exhibited predominantly restrictive or mixed defects linked to parenchymal fibrosis and biomass fuel exposure. Smoking and biomass use were major contributors to lung function decline. Targeted interventions such as smoking cessation, reducing biomass exposure, regular spirometry, and management of comorbidities are essential to improve long-term respiratory outcomes and quality of life in PT-LD patients. This abstract is funded by: Not Funded
Mahmood et al. (Fri,) studied this question.
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