review · Journal of the Pan African Thoracic Society
This narrative review challenges the long-held belief that post-tuberculosis lung disease (PTLD) is rare or clinically unimportant in children. Drawing on literature, particularly from high-burden African settings, it demonstrates that a significant number of children and adolescents experience persistent symptoms, impaired lung function, or radiographic changes after completing tuberculosis treatment. These sequelae can negatively affect their overall well-being, including growth, exercise tolerance, school participation, and quality of life. The review highlights current gaps in African practice, such as limited access to child-appropriate spirometry, variable quality of chest radiography, and weak referral pathways. It outlines priorities for action, including integrating structured post-treatment follow-up into paediatric TB care, strengthening diagnostic and rehabilitation capacity, and advancing African-led research to harmonise definitions and evaluate scalable service delivery models.
This research is important because it highlights that childhood tuberculosis can have lasting effects on lung health, impacting children's development and quality of life long after treatment. Recognising and addressing post-tuberculosis lung disease is crucial for improving the well-being of children in high-burden settings and ensuring comprehensive care beyond initial treatment.
The abstract indicates a need for improved diagnostic tools, such as child-appropriate spirometry and better quality chest radiography, and enhanced rehabilitation services for children with post-tuberculosis lung disease. This suggests opportunities for developing and deploying accessible diagnostic technologies and scalable rehabilitation programmes. The work is early-stage research informing policy and practice changes, aiming to strengthen healthcare capacity and integrate new care models within existing paediatric TB programmes.
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Childhood tuberculosis (TB) remains a major cause of morbidity and mortality in high-burden settings, with Africa carrying a disproportionate share of incident and undiagnosed disease. A longstanding cure-centered paradigm has reinforced the notion that post-TB lung disease (PTLD) in children is rare or clinically unimportant. In this narrative review, drawing on literature identified through PubMed and prioritizing evidence from high-burden African settings, we show that a meaningful subset of children and adolescents has persistent symptoms, impaired lung function, and/or radiographic sequelae after completing treatment. These sequelae may affect overall well-being, including growth, exercise tolerance, school participation, and health-related quality of life. Prospective cohort data, including a birth cohort with pre-TB measurements, strengthen causal inference by linking early-life TB to later respiratory impairment and age-dependent trajectories during critical windows of lung development. We describe current practice in Africa, highlighting gaps between guidance and implementation: Limited access to child-appropriate spirometry, variable quality and interpretation of chest radiography, constrained availability of computed tomography scans, and weak referral and rehabilitation pathways. Finally, we outline priorities to move from recognition to action: integrate structured post-treatment follow-up into pediatric TB care, strengthen diagnostic and rehabilitation capacity, embed PTLD indicators within national program monitoring, and advance African-led research to harmonize definitions, establish longitudinal cohorts, and evaluate scalable service delivery models aligned with universal health coverage goals.
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DOI: 10.25259/jpats_9_2026
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