Post-TB care
We are conducting a program of research at Barts Health NHS Trust (London, UK) to explore the effectiveness, cost-effectiveness, quality and acceptability of a newly-introduced long-term follow-up clinic for TB patients who have completed treatment but remain at high risk for long-term sequelae. These sequelae, which particularly affect patients who were treated for spinal TB, TB meningitis and MDR TB, include a wide range of physical, mental and social consequences. Whilst these sequelae are well described, their impacts on people with TB are less well documented, and to our knowledge, no formal or systematic approach to their monitoring has been provided, leading to a situation where post-TB care is often patchy and fragmented. We propose that introduction of a post-TB clinic will address this problem and consolidate care in a single service to ensure continuity of care from TB to post-TB with the same providers. Employing a longitudinal interview and questionnaire approach, we are using qualitative interviews to explore impacts of disease and difficulties and impacts of the new post-TB clinic on mental health and quality of life. Outcomes will include descriptive quantitative data; qualitative data including views on effectiveness and impact; and costs to enable cost-effectiveness analyses.
Additional work is on-going to study presentations and pathogenesis of post-TB lung disease in Indonesia.