Marieke M. Van der Zalm (South Africa)
Desmond Tutu TB Centre
Paediatrics & Child Health
I have always had a special interest in pediatric infectious diseases and lung health. My initial work as an undergraduate student on the role of respiratory viruses in children with cystic fibrosis resulted in my PhD proposal, which investigated the role of respiratory viruses in respiratory illnesses early in life in a large Dutch pediatric birth cohort. I was awarded a PhD fellowship in the Alexandre Suerman program for my PhD research, which included a 2-year bursary to conduct clinical research leading towards a PhD. Whilst performing my PhD research, I had the opportunity to improve my epidemiological skills by completing a Masters’ degree in Clinical Epidemiology at the University of Utrecht. After completion off my PhD I specialized to become a pediatrician. Based on my strong interest to work in sub-Saharan Africa, I completed part of my clinical training in pediatrics at Tygerberg Hospital, Stellenbosch University, South Africa and later also at Red Cross Childrens’ Hospital. During this time, I realized my passion was to improve health care in low- and middle-income countries (LMICs) like South Africa, by performing highly relevant clinical research to address the pressing health care issues experienced in these settings. I started working at the Desmond Tutu TB centre, Stellenbosch University in 2014 and have since received multiple grants for my work on lung health in children with pulmonary tuberculosis and respiratory viruses (including COVID-19), including NIH and EDCTP career fellowships.

Presenter of 1 Presentation

 Conference Calendar

LUNG FUNCTION IS IMPAIRED IN ADOLESCENTS WITH PULMONARY TUBERCULOSIS DURING TB TREATMENT

Session Name
0340 - Oral Presentations: LATE-BREAKING ABSTRACTS (ID 95)
Session Type
Oral Presentations
Date
Wed, 23.02.2022
Session Time
09:45 AM - 10:45 AM
Room
Sala E
Presenter
Lecture Time
10:15 AM - 10:25 AM

Abstract

Background

Despite accumulating data on the nature and burden of post-tuberculosis (TB) lung disease (PTLD) in adults, little is known about PTLD in adolescents.

Aims

To assess lung function in adolescents with pulmonary TB (PTB) during anti-tuberculosis treatment.

Methods

In a prospective cohort study, we enrolled adolescents aged 10-20 years routinely diagnosed with bacteriologically confirmed PTB and healthy TB-exposed adolescent controls, between October 2020 and July 2021 in Cape Town, South Africa. Spirometry, plethysmography and diffusion capacity lung function tests were completed according to ERS/ATS guidelines following 2 months of TB treatment (cases) and in healthy controls. Global initiative reference ranges were used to calculate z-scores.

Results

Eighty-six adolescents were enrolled; 42 (49%) with PTB and 44 (51%) healthy controls. The mean age was 14.9 years (SD 2.7), 6 (5.5%) were living with HIV and 9 (10.5%) had a previous history of TB. Post bronchodilation, spirometry z-scores for Forced Expiratory Volume in 1 second (FEV1), Forced Vital capacity (FVC) and FEV1/FVC were significantly lower in TB cases compared to controls. Plethysmography showed a significantly lower vital capacity in TB cases vs. controls, with slightly lower total lung capacity. Diffusion capacity was similar between TB cases and healthy controls.

figure1_teentb_spirozscore_v4.pngfigure3_teentb_diffusion_v3.pngfigure4_teentb_plethy_v3.png

Conclusions

The lung function in adolescents with PTB following the intensive phase of TB treatment was significantly impaired compared to that of healthy peers. Further follow-up is important to assess the long-term impact of PTB on lung function in adolescents and to correlate these findings with symptoms, imaging, functional assessments and disease severity at diagnosis.

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