A COMPARATIVE STUDY OF HEALTH-RELATED QUALITY OF LIFE AMONG HIV PATIENTS ON HAART AND PRE HAART IN UYO, AKWA IBOM STATE.

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A COMPARATIVE STUDY OF HEALTH-RELATED QUALITY OF LIFE AMONG HIV PATIENTS ON HAART AND PRE HAART IN UYO, AKWA IBOM STATE.

Abstract

INTRODUCTION
With the advent of Highly Active Antiretroviral Therapy (HAART), the survival of HIV/AIDS patients has been improved; thus the quality of life they live has become an important focus for health care providers and researchers. Assessing the Health related Quality of life, will give an insight to the patients’ perception of the burden of the disease, track changes in their health over time and assess the effect of management. The knowledge of the factors affecting quality of life will be helpful in policy decision and clinical intervention. The purpose of this study was to assess the HRQOL of PLWHA in Uyo.
MATERIALS AND METHODS
Newly enrolled HAART- naïve patients were recruited at University of Uyo Teaching Hospital and St Luke’s Hospital both in Uyo, for a longitudinal study. The patients were classified into Pre-HAART and HAART group based on their eligibility to commence HAART. WHOQOL-HIV Bref instrument was used to obtain information on the socio demographic, some clinical characteristics and the Health Related- Quality of Life (HR-QOL) at recruitment and at the end of four months.
RESULTS
Sixty – eight Pre HAART and 93 HAART respondents were successfully followed up. At recruitment, the HR-QOL of the Pre-HAART respondents was better than the HAART group across the domains, except the spirituality. The overall quality of life (QOL) was good in 56% of the Pre –HAART and 22% of HAART (p value=0.0001). While at four months both group became similar except at social and environmental domains where Pre HAART fared better.
There statistically significant predictors of good quality of life, among the Pre-HAART respondents at baseline were early disease stage (OR, 4.49, p value 0.018 CI, 1.29-15.55) and CD4 count (OR, 1.01; P value 0.029; CI, 1.0- 1.01). There was a significant association between level of education and QOL. The significant predictors of good quality of life among the HAART group were; being married (OR, 19.18; P value, CI, 2.38-165.3), early disease stage (OR, 3.1 P value 0.0001 CI, 0.09-98.2). Age and CD4 were significant at bivariate level.
At the end of four months, the predictors of good QOL among the Pre-HAART respondents was time of duration since diagnosis (OR, 0.95, P value 0.0001; CI, 0.92-0.98). Good adherence to medication was the only significant predictor of good QOL in the HAART respondents (OR, 5.2, P value 0.001 CI, 1.88-14.3).
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The Pre HAART respondents showed significant improvement in their overall QOL after four months (p value 0.0001) and in the psychological, social relationship and spirituality domains. The proportion of HAART respondents with good QOL increased with significant improvement in the physical, psychological, level of independence and in the spirituality domains.
Time duration since diagnosis has a weak negative correlation with HR QOL of Pre HAART respondents at four months
CONCLUSION
In this study, a short term use of HAART over four months is associated with improvement in HR-QOL across the domains except the social and environmental domains. The Pre- HAART group showed considerable improvement in their HR-QOL in the absence of antiretroviral drugs. Early clinical stage predicts better QOL in both groups. While in the HAAART group adherence to medication is a strong predictor of good QOL. Among the Pre- HAART group the QOL decreases as the time since diagnosis increases which means that the Pre- HAART group will eventually need HAART in the future.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

A COMPARATIVE STUDY OF HEALTH-RELATED QUALITY OF LIFE AMONG HIV PATIENTS ON HAART AND PRE HAART IN UYO, AKWA IBOM STATE.

 

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