Post-Tuberculosis Burden

🧬 Leading-Edge Research on Tuberculosis

Long-Term Outcomes After TB Disease

📜 Background

Tuberculosis (TB) is a model of chronic respiratory infection. During my PhD, I conducted population-based, longitudinal research on TB in São Paulo State, Brazil (~44 million inhabitants), following patients newly diagnosed between 2010–2015 for over five years.

At the start of Otavio’s PhD, Post-TB Lung Disease was an emerging field, which has now become consolidated and is gaining importance, particularly in quantifying the long-term burden of TB. Using record linkage methods between administrative and health big databases, we quantified mortality and cause-specific outcomes, contributing foundational knowledge to this area.

We also considered the vulnerable determinants of long-term outcomes of TB, including biological (diabetes and mental diseases), social (homelessness and incarcerated individuals) and health behaviour (alcohol and drug use).

🔬 My Contribution

• Big Data Integration: Linked multiple big databases to track TB patients longitudinally.
• Study Design & Analysis: Led the design, statistical analysis, and interpretation of long-term outcomes.
• Publications & Dissemination: First-author on a landmark Lancet Infect Dis study, plus three additional TB articles from my thesis.

🌍 Impact

• Provided robust evidence on long-term mortality after TB.
• Contributed to the consolidation of Post-TB Lung Disease as an important research area, particularly in quantifying its burden.
• Influenced national TB program strategies, including recommendations for post-TB patient care.
• Findings cited in Post-TB Lung Disease guidelines and discussed in national/international media.
• Advanced understanding of determinants, prognostic biomarkers, and potential mitigation strategies for post-TB sequelae.

This project was funded by the Wellcome Trust.

Key Publication:
Ranzani OT, Rodrigues LC, Bombarda S, et al. (2020). Long-term survival and cause-specific mortality of patients newly diagnosed with tuberculosis in São Paulo state, Brazil, 2010-15: a population-based, longitudinal study. Lancet Infect Dis. 20(1):123–132. doi: 10.1016/S1473-3099(19)30518-3.