COMPARATIVE STUDY OF THE HEALTH-RELATED QUALITY OF LIFE OF ADULT PATIENTS WITH TUBERCULOSIS AND THOSE WITH TUBERCULOSIS AND HIV/AIDS CO-INFECTION ATTENDING DOTS CENTRE IN MAINLAND GENERAL HOSPITAL, LAGOS STATE

Abstract

Introduction: Health Related Quality of Life is a multidimensional construct referring to patients’ perception of the impact of disease and treatment on their physical, psychological, social function and well-being. Its importance is increasing worldwide in assessing the effectiveness of treatments or management in improving outcomes and quality of life. Tuberculosis and Human Immunodeficiency Virus infection are two diseases of public health importance in Nigeria. Not much is known about the impact of these two diseases on the quality of life of patients in Nigeria. This study was carried out to measure, compare and identify factors affecting the health-related quality of life of patients with tuberculosis and TB/HIV co-infection amongst adult patients attending the treatment centre of Mainland General Hospital in Lagos State.
Methodology: This was a comparative cross-sectional study of 135 patients with tuberculosis only and 135 TB/HIV co-infected patients. Every consecutive patient who met the inclusion criteria was recruited over three months. Interviewer administered questionnaires were used to collect data on socio-demographic, socio-economic, and lifestyle information from consenting patient. Medical information on TB category, antiretroviral drug use and duration of anti-tuberculosis treatment was retrieved from record files. The questionnaire adapted the 26-item WHO Quality of Life instrument-short version (WHOQOL-BREF) to measure the HRQOL of these patients.
Results: The mean ages were 34.93+13.06 and 40.03+10.48 amongst those with tuberculosis only and tuberculosis/HIV co-infection respectively (p=0.001). Majority in the TB/HIV co-infection group were females (65.9%) and 54.1% in the
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tuberculosis only group were males. Over two-thirds in both groups had a minimum of secondary school education with 71.8% of patients with tuberculosis only and 67.4% with TB/HIV co-infection in the lower social classes IV and V. The mean score for HRQOL ranged from 59.96 to 69.26 in the tuberculosis only group and 53.31 to 67.41 in the TB/HIV co-infection group. The social relationship domain had the highest influence on the global domain score for both groups. The TB/HIV co-infected group had lower QOL in only the social relationship domain (p=0.009) and had more respondents with good satisfaction of health (p=0.045) compared to those in tuberculosis only group. Males had a better HRQOL compared to females in the tuberculosis only group (p=0.019). The proportion of respondents with good HRQOL increased as family monthly income increased in the tuberculosis only group (p=0.016). Other factors showed no statistically significant association (p>0.05).
Conclusion: Both groups had an average mean score of quality of life and were not significantly different in terms of their physical, psychological and environmental health domains. However, TB/HIV co-infected patients had lower mean scores in the social relationship domain compared to those with TB. Gender and family monthly income were the only significant factors found to affect quality of life.
Recommendations: There is a need to improve social support and ease the effect of stigma and discrimination of people living with TB and HIV, by including families and friends in the counseling and management of such patients. There is also the need to research into the area of social relationships and the challenges these patients face, as it affects the quality of life of patients with TB and TB/HIV co-infection.

COMPARATIVE STUDY OF THE HEALTH-RELATED QUALITY OF LIFE OF ADULT PATIENTS WITH TUBERCULOSIS AND THOSE WITH TUBERCULOSIS AND HIV/AIDS CO-INFECTION ATTENDING DOTS CENTRE IN MAINLAND GENERAL HOSPITAL, LAGOS STATE