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Systematic review and meta-analysis shows reduced lung function in children with post-tuberculosis treatment compared to healthy controlsChildren treated for TB may face lasting lung damage

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Key Takeaway
Note significant reductions in FEV1 and FVC in children with post-tuberculosis treatment compared to healthy controls.

This systematic review and meta-analysis examined pooled mean z-scores for FEV1, FVC, and FEV1/FVC ratio in children (≤18 years) with pulmonary tuberculosis following treatment compared to healthy controls. Nine studies were included in the analysis, though the specific setting was not reported. The primary outcomes focused on spirometric parameters to assess potential long-term respiratory sequelae.

In the pooled analyses, significant reductions were observed for FEV1 (effect size: -1.51; 95% CI -2.38 to -0.64) and FVC (effect size: -1.36; 95% CI -2.60 to -0.12). Conversely, the FEV1/FVC ratio showed no significant deviation in the pooled data (effect size: 0.04; 95% CI -1.29 to 1.37). When comparing cases directly to controls, FEV1 was significantly lower (Hedges' g = -0.46; 95% CI -0.78 to -0.13) and FVC was significantly lower (Hedges' g = -0.29; 95% CI -0.50 to -0.08). The FEV1/FVC ratio in this comparison showed a marginal decline (Hedges' g = -0.32; 95% CI -0.58 to -0.06).

The authors note that estimates vary substantially across studies, with heterogeneity across analyses being moderate to high (I2 = 55%–98%). Safety data, including adverse events and tolerability, were not reported. The authors caution that pooled effect sizes should be interpreted as indicative of association rather than precise estimates of magnitude, reflecting the limitations inherent in the included observational data.

A new analysis of nine studies suggests that children who have been treated for pulmonary tuberculosis (PTB) may continue to have reduced lung function, even after they are considered cured. The review compared lung function measurements—specifically the amount of air a child can forcefully exhale in one second (FEV₁) and the total volume of air they can exhale (FVC)—between children who had completed TB treatment and healthy children.

The results showed that children who had been treated for TB had significantly lower FEV₁ and FVC scores compared to healthy controls. On average, their FEV₁ was about 1.5 standard deviations below normal, and FVC was about 1.4 standard deviations below normal. The ratio of FEV₁ to FVC, which helps distinguish different types of lung problems, was not significantly different overall, though there was a marginal decline when compared directly to controls.

It is important to note that these findings come from a meta-analysis of existing studies, and the results varied widely across the individual studies. The researchers caution that the pooled estimates should be seen as indicating an association, not as precise measurements of the actual lung function loss. No information was provided on whether these children had any symptoms or needed ongoing treatment.

For parents and doctors, this review highlights that lung function may not fully recover after TB treatment in children. However, more research is needed to understand how common these problems are and whether they affect daily life or long-term health.

What this means for you:
Children treated for TB may have lasting reductions in lung function, but more research is needed.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
BackgroundPulmonary tuberculosis (PTB) in childhood can result in persistent lung function impairment in adults, but data among children remain limited. This systematic review and meta-analysis aimed to summarize and update current evidence on pulmonary function outcomes after PTB treatment in children.MethodsWe searched PubMed, Embase, Web of Science, and Scopus up to October 23, 2025. Eligible studies included children (≤18 years) with PTB who underwent post-treatment spirometry. Pooled mean z-scores for FEV₁, FVC, and FEV1/FVC ratio were calculated using random-effects models. For comparative studies, standardised mean differences (Hedges’ g) were derived to compare post-PTB children with healthy controls.ResultsNine studies were included. The pooled post-treatment mean z-scores indicated significant reductions in both FEV₁ (−1.51, 95% CI −2.38 to −0.64) and FVC (−1.36, 95% CI −2.60 to −0.12), while the FEV1/FVC ratio showed no significant deviation (0.04, 95% CI −1.29 to 1.37). In case-control comparisons, post-PTB children had significantly lower FEV₁ (Hedges’ g = −0.46, 95% CI −0.78 to −0.13) and FVC (Hedges’ g = −0.29, 95% CI −0.50 to −0.08) compared with controls, while the FEV1/FVC ratio (Hedges’ g = −0.32, 95% CI −0.58 to −0.06) showed only a marginal decline. Heterogeneity across analyses was moderate to high (I2 = 55%–98%).ConclusionsThis updated systematic review and meta-analysis indicates that children who have completed PTB treatment frequently exhibit FEV₁ and FVC values below age matched reference levels, although estimates vary substantially across studies. Pooled effect sizes should be interpreted as indicative of association rather than precise estimates of magnitude. Additional prospective, microbiologically confirmed, and age-specific studies are necessary to better understand the long-term effects of childhood TB on lung development.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, PROSPERO CRD420251166413.
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