India needs to focus on pulmonary rehabilitation to combat post-TB lung sequelae: experts

Tuberculosis (TB) remains a significant global health concern, with 1.25 million deaths reported in 2023, according to the World Health Organization.

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India bears a substantial burden, accounting for 26% of global TB cases and 26% of TB-related deaths.According to the Indian Journal of Respiratory Care (2022) and studies by The Lancet journal, many TB survivors continue to suffer from long-term lung damage, including fibrosis (scarring of lung tissue that reduces elasticity and impairs breathing), cavitation (formation of hollow spaces in the lungs due to tissue destruction), and airflow obstruction, despite completing their treatment.

These post-TB complications often lead to chronic respiratory impairment, reduced quality of life, and economic hardships due to lost wages and ongoing medical expenses. Hence, this calls for a renewed focus on comprehensive care, including palliative care and rehabilitation. The second UN high-level meeting on TB in 2023 made commitments to address these long-term consequences of TB, recognising the critical need for post-TB care.The WHO, through its End TB Strategy, aims to eradicate TB by 2030, and India’s National Tuberculosis Elimination Programme (NTEP) has laid out post-TB follow-up guidelines to diagnose and manage complications. However, the practical implementation of these guidelines remains inconsistent, leaving many survivors without access to proper rehabilitation.

What is pulmonary rehabilitation and its status in India ?

According to the American Thoracic Society (ATS) and the European Respiratory Society (ERS), pulmonary rehabilitation (PR) is a multidisciplinary intervention designed to improve both the physical and emotional well-being of patients with chronic respiratory diseases. It is widely recognised as one of the most cost-effective treatments for improving lung function and overall quality of life. The Indian Journal of Respiratory Care identifies PR as the most effective and evidence-based tool to manage post-TB sequelae, helping to prevent further morbidity and mortality while improving patient outcomes.