Editorial: Long TB: Framing post-acute sequelae of tuberculosis as a distinct clinical entity, Kumar et al, 2026

Kalliope

Senior Member (Voting Rights)
Journal of Family Medicine and Primary Care

Abstract

Tuberculosis (TB) has historically been declared cured at the point of microbiological clearance. Yet emerging evidence from systematic reviews and cohort studies demonstrates that between 30% and 80% of pulmonary TB survivors experience persistent symptoms, organ damage or functional impairment after treatment completion; a burden that existing outcome metrics fail to capture.

We propose the term Long TB, with the formal designation Post-Acute Sequelae of Tuberculosis (PAST-TB), as a conceptual and clinical framework to define, study and address this under-recognised morbidity. Drawing explicit parallels with Long COVID (post-acute sequelae of SARS-CoV-2 or PASC), we argue that the Long TB framing is not merely rhetorical but scientifically grounded, strategically powerful and urgently needed.

With approximately 155 million TB survivors alive globally and modelling studies attributing up to 47% of TB-related disability-adjusted life years (DALYs) to the post-treatment period, the case for a systematic post-TB care agenda, anchored by this new terminology is compelling.

We attempt to outline the multi-system domains of Long TB, its shared pathological drivers with PASC and the programmatic and research reforms required to move from bacteriological to biological cure as the standard of care.

 
I don’t think they are going to get much benefit from using «long». It implies that the TB is unresolved, which it presumably isn’t.

«Post-acute» also doesn’t seem right, because the problems caused by TB often start years after the initial infection because the infection is left untreated.
 
I don’t think they are going to get much benefit from using «long». It implies that the TB is unresolved, which it presumably isn’t.

Long term sequelae of TB were well discussed when I was a junior - including 'Poncet's Disease'. Yes, people go on being ill but I can see nothing to be gained by bundling this in to a 'Long-Disease' concept. It won't catch on.
 
emerging evidence from systematic reviews
Yeah, this whole evidence-based medicine thing is really not fit for purpose, is it? The evidence might be emerging in their fantasy literature, but it's been known for a long time, but like all post-infectious sequelae has been systematically denied and suppressed. Which is a much broader and problematic issue. What is the true value of expert literature if it's so damn unreliable at the best of times?
Long term sequelae of TB were well discussed when I was a junior - including 'Poncet's Disease'. Yes, people go on being ill but I can see nothing to be gained by bundling this in to a 'Long-Disease' concept. It won't catch on.
How is it different? It's clear that this is rather common with many infections, and ties in with both concepts of post-viral fatigue and ME/CFS. The name might be a bit awkward but that's what happens when a problem is ignored indefinitely, it catches from other sources. Problems without a name or a concept rarely get solved.

This is all a huge mess. I don't know if any other profession has caused any mess a fraction of this size, and clearly it's not moving any time soon.
 
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