Clinical and radiological sequelae of pulmonary tuberculosis in a primary care network of Metropolitan Lima

Castillo O.J.; Barreto A.U.; Orihuela Y.Y.; Tutaya Gonzales L.A. · Anales de la Facultad de Medicina (2025) · DOI: 10.15381/anales.v86i3.30613

Resumen

Introduction. Information on the prevalence of tuberculosis (TB) sequelae in primary care centers is very limited, as most studies have been conducted in hospitals. International TB expert organizations encourage epidemiological studies on post-TB sequelae. Objective. To determine the prevalence of clinical and radiological sequelae after pulmonary TB (PTB) treatment in primary care facilities in a Peruvian city. Methods. We conducted a cross-sectional prevalence study of symptoms and radiological and tomographic sequelae. We selected eight facilities with the highest number of TB patients from the Lima Centro Health Directorate. Patients were included if they met the following criteria: bacteriologically confirmed PTB, susceptible to RMP/RMP-INH by molecular methods, completion of the supervised first-line regimen 2RHZE/4(RH)3, and discharge as cured with negative smear microscopy. A standardized questionnaire was applied, and chest X-ray and CT scans were provided free of charge and reviewed by two pulmonologists and one radiologist. The presence of sequelae was determined by simple majority. Results. A total of 82 post-treated PTB patients participated. The most frequent symptoms were fever (19.5%), dyspnea (17.1%), and chest pain (13.4%). The most frequent radiographic sequelae were fibrosis (90.2%), calcifications (28.0%), and total bronchiectasis (15.9%). The most frequent tomographic sequelae were fibrosis (97.6%), cylindrical bronchiectasis (86.6%), pachypleuritis (48.8%), calcifications (25.6%), atelectasis (19.5%), and tree-in-bud pattern (14.6%). Conclusion. The prevalence of post-treatment pulmonary TB sequelae in patients treated at the primary care level is high, particularly fibrosis and bronchiectasis.