Lume Ivan2026-09-242026-09-242026-09-01https://bdears.busitema.ac.ug/handle/123456789/9689Background Tuberculosis (TB) remains the leading cause of death from a single infectious disease, with Africa contributing substantially to the global burden. Although improvements in early diagnosis and treatment have increased treatment success rates, a considerable proportion of TB survivors develop persistent respiratory impairment, including abnormal lung function after completion of treatment. Objectives: To determine the prevalence, patterns and factors associated with abnormal lung functions among TB survivors managed at Mbale Regional Referral Hospital (MRRH), between January 2020 and December 2024. Methods: We conducted a cross-sectional study among 309 TB survivors managed at MRRH. Sociodemographic and clinical data were extracted from medical records. Lung function was assessed using pre- and post-bronchodilator spirometry to determine forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), and spirometry patterns were classified as obstructive, restrictive, mixed, or normal. Data were analysed using Stata 17. Bivariate and multivariable analyses were performed using modified Poisson regression to identify factors associated with abnormal lung function. Results: Most participants were male, 176 (57.0%), and the mean age was 42.0 years (SD 12.2). Overall, the prevalence of abnormal lung function was 163 (52.8%). The most common spirometry abnormality was an obstructive pattern, 88 (28.5%), followed by a restrictive pattern, 62 (20.1%), and a mixed pattern, 13 (4.2%). In multivariable analysis, outpatient status at the time of TB diagnosis (aPR 1.34; 95% CI: 1.05–1.71; p=0.021), rural residence (aPR 1.34; 95% CI: 1.06–1.69; p=0.015), exposure to biomass fuel (aPR 1.58; 95% CI: 1.06–2.35; p=0.024), and having more than one previous episode of TB (aPR 1.41; 95% CI: 1.08–1.83; p=0.011) were significantly associated with abnormal lung function. Conclusion: Abnormal lung function was common among TB survivors at MRRH, affecting more than half of the study participants. Obstructive lung function abnormality was the predominant spirometry pattern. Outpatient status at TB diagnosis, rural residence, biomass fuel exposure and recurrent TB were independently associated with abnormal lung function. These findings highlight the need for structured post-TB respiratory follow-up, including spirometry screening and targeted interventions for high-risk survivors.en