Management and outcomes of post-tuberculosis thoracic complications: a retrospective case series from a national referral center in Burkina Faso

Abstract

Abstract Background Post-tuberculosis (TB) thoracic complications and sequelae are increasingly recognized as major contributors to chronic respiratory morbidity but remain underreported, particularly in resource-limited and TB-endemic settings. In Burkina Faso, the surgical burden of these conditions is poorly documented. This study aimed to describe the clinical patterns, surgical management, and outcomes of post-TB thoracic conditions at the national cardiothoracic referral center. Methods We conducted a retrospective case series at Tengandogo University Hospital (Ouagadougou) from December 2020 to December 2023. All patients managed for post-TB thoracic conditions were included. Sociodemographic, clinical, radiological, therapeutic, and outcome data were extracted from medical records. Descriptive statistics were performed, and associations were assessed using Pearson’s chi-square test ( p < 0.05). Multivariable logistic regression was conducted to identify independent predictors of symptom resolution. Results Among 1,294 admissions, 94 patients (7.3%, 95% CI: 5.9–8.8%) presented with post-TB thoracic conditions requiring surgical evaluation. Of 586 surgical procedures performed during the study period, 68 (11.6%, 95% CI: 9.1–14.5%) were related to post-TB conditions. Patients were predominantly male (88.3%), with a mean age of 40 ± 16 years. The most common diagnoses were chronic pyothorax / Pyopneumothorax (42.6%, 95% CI: 32.5–53.5%) and pulmonary aspergilloma (24.5%, 95% CI: 16.2–34.4%). Surgical treatment was performed in 72.3% (68/94) of patients, including chest tube drainage (30/68, 44.1%), lobectomy (12/68, 17.6%), and decortication (7/68, 10.3%). The mean hospital stay was 13 ± 8 days, and overall mortality was 7.4% (7/94, 95% CI: 3.0–14.6%). After adjusting for age, diagnosis type, and disease severity, surgical management was associated with absence of residual symptoms at discharge (adjusted OR 12.4, 95% CI: 4.2–36.7, p < 0.001) ; however, this finding is limited by confounding by indication, as surgically treated patients were younger and had more favourable baseline characteristics. Median follow-up was 6 months (IQR 3–12), with symptom resolution maintained in 82% of surgical patients. Conclusions Post-TB thoracic complications and sequelae represent a substantial surgical burden in Burkina Faso. These conditions predominantly affect young, economically active individuals and are often associated with delayed presentation. Improved post-TB follow-up programs and strengthened surgical capacity are needed to optimize patient outcomes in resource-limited settings.