University of Leicester
Browse
A pre-post intervention study of pulmonary rehabilitation for adults with post-tuberculosis lung disease in Uganda.pdf (343.61 kB)

A pre-post intervention study of pulmonary rehabilitation for adults with post-tuberculosis lung disease in Uganda.

Download (343.61 kB)
journal contribution
posted on 2019-06-20, 09:00 authored by R Jones, BJ Kirenga, W Katagira, SJ Singh, J Pooler, A Okwera, R Kasiita, DG Enki, S Creanor, A Barton
Setting: The study was conducted at Mulago Hospital, Kampala, Uganda. Objective: As chronic respiratory disease (CRD) is a huge, growing burden in Africa, with few available treatments, we aimed to design and evaluate a culturally appropriate pulmonary rehabilitation (PR) program in Uganda for people with post-tuberculosis lung disorder (p-TBLD). Design: In a pre-post intervention study, a 6-week, twice-weekly PR program was designed for people with p-TBLD. Outcome measures included recruitment, retention, the Clinical COPD Questionnaire (CCQ), tests of exercise capacity, and biometrics. Given this was a developmental study, no formal statistical significance testing was undertaken. Results: In all, 34 participants started PR and 29 (85%) completed all data collection. The mean age of the 29 participants was 45 years, and 52% were female. The mean (95% confidence interval) CCQ score at baseline was 1.8 (1.5, 2.0), at the end of PR was 1.0 (0.8, 1.2), and at 6 weeks after the end of PR was 0.8 (0.7, 1.0). The Incremental Shuttle Walking Test (ISWT) was 299 m (268.5, 329.4) at baseline, 377 (339.6, 413.8) at the end of PR, and 374 (334.2, 413.5) at 6 weeks after the end of PR. Improvements were seen in measures of chest pain; 13/29 (45%) participants reported chest pain at baseline but only 7/29 (24%) at the end of PR, and in those with persistent pain, the mean pain scores decreased. Mild hemoptysis was reported in 4/29 (17%) participants at baseline and in 2/29 (7%) at the end of PR. Conclusion: PR for people with p-TBLD in Uganda was feasible and associated with clinically important improvements in quality of life, exercise capacity, and respiratory outcomes. PR uses local resources, requires little investment, and offers a new, sustainable therapy for p-TBLD in resource-limited settings. With the rising global burden of CRD, further studies are needed to assess the value of PR in p-TBLD and other prevalent forms of CRD.

Funding

This research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust. This study was a performed in association with the Fresh Air group and was a demonstration project for the World Health Organization (Global Alliance against CRDs). The study was funded by a Joint Global Health Development grant from the UK Medical Research Council, the Wellcome Foundation and the UK Government Department for International Development fund.

History

Citation

International Journal of Chronic Obstructive Pulmonary Disease, 2017, 12, pp. 3533-3539

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Infection, Immunity and Inflammation

Version

  • VoR (Version of Record)

Published in

International Journal of Chronic Obstructive Pulmonary Disease

Publisher

Dove Medical Press

eissn

1178-2005

Acceptance date

2017-09-07

Copyright date

2017

Available date

2019-06-20

Publisher version

https://www.dovepress.com/a-pre-post-intervention-study-of-pulmonary-rehabilitation-for-adults-w-peer-reviewed-article-COPD

Language

en