Assesment of Health-Related Quality of Life in Post-Tuberculosis Lung Disease Patients: A Cross Sectional Comparative Study
Author(s):
Odinaka CV, Onyedum CC, Udeh CF, Mbata GC, Eke COU, Nwosu NI, Nlewedim PA, Obiefuna AG, Chukwuka JC and Agu FC
Background: Tuberculosis is a disease of public health importance because of its high morbidity and mortality and also its communicable nature. Pulmonary tuberculosis is an airborne respiratory disease caused by Mycobacterium tuberculosis. It is one of the oldest diseases known to affect man and is a major cause of death globally. Patients treated for pulmonary tuberculosis and cured can come down with poor health-related quality of life and impaired lung function although this has not been extensively studied. This study assessed the quality of life of post-tuberculosis lung disease patients. Aim: The study was done to assess health-related quality of life in post-tuberculosis lung disease patients.
Methods: This was a hospital based cross sectional comparative study of post-pulmonary tuberculosis patients attending Federal Teaching Hospital, Owerri, who had completed treatment for tuberculosis at the point of treatment completion down/up to 2 years previously. Interviewer based questionnaire was administered to study participant to obtain data regarding socio-demographics. Other relevant clinical data including health-related Quality of Life of participants were collected using St George’s respiratory Questionnaire. All participants were subjected to spirometry procedure to measure the ventilatory function parameters using spirolab III. Data was analyzed using IBM SPSS statistics version 25.0. Chi-square was used to determine association between categorical variables. The independent student t-test was used to compare continuous data while one-way ANOVA test was used to compare mean lung volumes of participants across the patterns of lung function with post hoc analysis conducted as appropriate. The Holmes-Bonferonni method was used to correct the analysis for multiple testing. Spearman rank correlation analysis was conducted between the lung volumes and median values of the symptom, impact and activity domains of the St George’s Respiratory Questionnaire. A two-sided level of significance of 5% was used in all the analyses.
Results: Out of the 200 participants recruited, consisting of 100 post-tuberculosis lung disease patients (18 years and above) and 100 age-, sex- and height-matched apparently healthy controls; mean age: 48.0±15.2 for cases and 46.7±13.9 for controls. The most frequent respiratory symptom was cough and sputum production which was present in 56 (56%) and 51 (51%). Respiratory lung function impairment occurred in 71% of cases and 12% of the control. The SGRQ component score for symptoms was 17.1 (IQR 16.8-40.8) followed by impact 1.05 (IQR 0-30.26) and total components 7.48 (IQR 1.20-34.51) for post-TB individuals and none for controls, Also, the current health status were significantly lower in post-TB cases (p = <0.001) compared to controls.
Conclusion: Overall, health-related quality of life was significantly reduced across the symptom and impact domains in post-TB individuals compared to healthy controls, highlighting the significant impact of pulmonary tuberculosis on affected individuals even after successful treatment.