Tuberculosis-associated respiratory impairment and disability in children, adolescents and adults: protocol for a systematic review and individual participant data meta-analysis

Background Approximately 2% of the global population has survived tuberculosis (TB). Increasing evidence indicates that a significant proportion of pulmonary TB survivors develop TB-associated respiratory impairment and disability—commonly referred to as post-TB lung disease—marked by impaired respi...

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Main Authors: Andrea Benedetti, Dick Menzies, Kamila Romanowski, Faiz Ahmad Khan, Mayara Lisboa Bastos, Silvia S. Chiang, James C. Johnston, Alexandre Petiquan, Sierra A. Land, Marieke M. van der Zalm, Jonathon R. Campbell
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/3/e094118.full
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author Andrea Benedetti
Dick Menzies
Kamila Romanowski
Faiz Ahmad Khan
Mayara Lisboa Bastos
Silvia S. Chiang
James C. Johnston
Alexandre Petiquan
Sierra A. Land
Marieke M. van der Zalm
Jonathon R. Campbell
author_facet Andrea Benedetti
Dick Menzies
Kamila Romanowski
Faiz Ahmad Khan
Mayara Lisboa Bastos
Silvia S. Chiang
James C. Johnston
Alexandre Petiquan
Sierra A. Land
Marieke M. van der Zalm
Jonathon R. Campbell
author_sort Andrea Benedetti
collection DOAJ
description Background Approximately 2% of the global population has survived tuberculosis (TB). Increasing evidence indicates that a significant proportion of pulmonary TB survivors develop TB-associated respiratory impairment and disability—commonly referred to as post-TB lung disease—marked by impaired respiratory function, persistent symptoms and activity limitations. However, the prevalence, risk factors and progression of TB-associated respiratory disability throughout the life course are not well understood. To address these gaps, we will undertake a systematic review and individual participant-level data meta-analysis (IPD-MA) focusing on TB-associated respiratory impairment and disability in children, adolescents and adults successfully treated for pulmonary TB.Methods and analysis We will systematically search MEDLINE, Embase, CENTRAL, Global Index Medicus and medRxiv for original studies investigating TB-associated respiratory impairment and disability in people of all ages who have completed treatment for microbiologically confirmed or clinically diagnosed pulmonary TB. Authors of eligible studies will be invited to contribute deidentified data and form a collaborative group. Primary outcomes will be (1) abnormal lung function based on spirometry parameters and (2) chronic respiratory symptoms. We will estimate the overall and subgroup-specific prevalence of each outcome through IPD-MA. Next, we will develop clinical prediction tools assessing the risk of future TB-associated respiratory impairment and disability. Finally, we will use stepwise hierarchical modelling to identify epidemiological determinants of respiratory impairment and disability.Ethics and dissemination This study has been approved by the ethics review boards at the Rhode Island Hospital (2138217-2) and the Research Institute of the McGill University Health Centre (2024-10345). Individual study authors will be required to obtain institutional approval prior to sharing data. Results will be disseminated through open-access, peer-reviewed publications and conference presentations.PROSPERO registration number CRD42024529906.
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spelling doaj-art-cc7d976af0c84e41a1feac12ef6523b02025-08-20T01:50:01ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-094118Tuberculosis-associated respiratory impairment and disability in children, adolescents and adults: protocol for a systematic review and individual participant data meta-analysisAndrea Benedetti0Dick Menzies1Kamila Romanowski2Faiz Ahmad Khan3Mayara Lisboa Bastos4Silvia S. Chiang5James C. Johnston6Alexandre Petiquan7Sierra A. Land8Marieke M. van der Zalm9Jonathon R. Campbell1010 Departments of Medicine and of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada8 McGill International TB Centre, Montreal, Quebec, Canada3 BC Centre for Disease Control, Vancouver, British Columbia, Canada8 McGill International TB Centre, Montreal, Quebec, Canada7 Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada2 Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA3 BC Centre for Disease Control, Vancouver, British Columbia, Canada6 University of Ottawa, Ottawa, Ontario, Canada6 University of Ottawa, Ottawa, Ontario, Canada12 Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Desmond Tutu TB Centre, Cape Town, Western Cape province, South Africa8 McGill International TB Centre, Montreal, Quebec, CanadaBackground Approximately 2% of the global population has survived tuberculosis (TB). Increasing evidence indicates that a significant proportion of pulmonary TB survivors develop TB-associated respiratory impairment and disability—commonly referred to as post-TB lung disease—marked by impaired respiratory function, persistent symptoms and activity limitations. However, the prevalence, risk factors and progression of TB-associated respiratory disability throughout the life course are not well understood. To address these gaps, we will undertake a systematic review and individual participant-level data meta-analysis (IPD-MA) focusing on TB-associated respiratory impairment and disability in children, adolescents and adults successfully treated for pulmonary TB.Methods and analysis We will systematically search MEDLINE, Embase, CENTRAL, Global Index Medicus and medRxiv for original studies investigating TB-associated respiratory impairment and disability in people of all ages who have completed treatment for microbiologically confirmed or clinically diagnosed pulmonary TB. Authors of eligible studies will be invited to contribute deidentified data and form a collaborative group. Primary outcomes will be (1) abnormal lung function based on spirometry parameters and (2) chronic respiratory symptoms. We will estimate the overall and subgroup-specific prevalence of each outcome through IPD-MA. Next, we will develop clinical prediction tools assessing the risk of future TB-associated respiratory impairment and disability. Finally, we will use stepwise hierarchical modelling to identify epidemiological determinants of respiratory impairment and disability.Ethics and dissemination This study has been approved by the ethics review boards at the Rhode Island Hospital (2138217-2) and the Research Institute of the McGill University Health Centre (2024-10345). Individual study authors will be required to obtain institutional approval prior to sharing data. Results will be disseminated through open-access, peer-reviewed publications and conference presentations.PROSPERO registration number CRD42024529906.https://bmjopen.bmj.com/content/15/3/e094118.full
spellingShingle Andrea Benedetti
Dick Menzies
Kamila Romanowski
Faiz Ahmad Khan
Mayara Lisboa Bastos
Silvia S. Chiang
James C. Johnston
Alexandre Petiquan
Sierra A. Land
Marieke M. van der Zalm
Jonathon R. Campbell
Tuberculosis-associated respiratory impairment and disability in children, adolescents and adults: protocol for a systematic review and individual participant data meta-analysis
BMJ Open
title Tuberculosis-associated respiratory impairment and disability in children, adolescents and adults: protocol for a systematic review and individual participant data meta-analysis
title_full Tuberculosis-associated respiratory impairment and disability in children, adolescents and adults: protocol for a systematic review and individual participant data meta-analysis
title_fullStr Tuberculosis-associated respiratory impairment and disability in children, adolescents and adults: protocol for a systematic review and individual participant data meta-analysis
title_full_unstemmed Tuberculosis-associated respiratory impairment and disability in children, adolescents and adults: protocol for a systematic review and individual participant data meta-analysis
title_short Tuberculosis-associated respiratory impairment and disability in children, adolescents and adults: protocol for a systematic review and individual participant data meta-analysis
title_sort tuberculosis associated respiratory impairment and disability in children adolescents and adults protocol for a systematic review and individual participant data meta analysis
url https://bmjopen.bmj.com/content/15/3/e094118.full
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