Evaluation of Health-Related Quality of Life among Tuberculosis Patients in Two Cities in Yemen

Abstract

BackgroundThe health-related quality of life (HRQoL) of Tuberculosis (TB) patients is important because it directly influences the outcome of TB patients in several aspects. The current study aims to evaluate and to find the factors influencing the HRQoL of TB patients in two major TB-prevalent cities (Taiz and Alhodidah) in Yemen.MethodsA prospective study was conducted, and all TB patients meeting the HRQoL criteria were asked to complete the HRQoL SF-36 survey. The records of TB patients were examined for disease confirmation, and a follow-up was consequently performed for patients during treatment between March 2013 and February 2014 in Taiz and Alhodidah Cities. HRQol scores were calculated by using QM scoring software version 4.5, in which the physical component score (PCS) and mental component score (MCS) were obtained. The scores obtained between 47–53 normal based score (NBS) were considered equivalent to the US normal score. Low scores indicate the poor health situation of TB patientsResultsA total of 243 TB patients enrolled in the study at the beginning of the treatment. A total of 235 and 197 TB patients completed the questionnaire at the end of the intensive phase (I.P.) and continuation phase (C.P.), respectively. The final dropout rate was 16.2%. The mean PCS and MCS scores at the beginning of treatment were low, thus showing the poor health situation of TB patients. The mean PCS scores at the beginning of treatment, end of I.P., and end of treatment were (36.1), (44.9), and (48), respectively. Moreover, the mean MCS score at the beginning of treatment, end of I.P., and end of treatment were (35.1), (42.2), and (44.3), respectively. The result shows that significant increases are observed at the end of I.P. for PCS and MCS because of the treatment and slight changes at the end of C.P. Despite this finding, the MCS score remains below the normal range (47), thus indicating a significant risk of depression among TB patients. Furthermore, general linear repeated measure ANOVA was performed for selected variables, to examine the changes of PCS and MCS over time. It was found that Alhodiah city, chewing khat habit, stigmatization, and duration of treatment more than six months were greatly associated with low mean MCS score of TB patient, indicating great risk of depression which may result in poor treatment outcome.ConclusionTB patients in Yemen were found to have poor QoL, with a significant likelihood of depression. Highly risk depression was found among TB patients in Alhodiah city, khat chewers, stigmatization and having a duration of treatment more than 6 months. Therefore, additional efforts should be made to improve their QoL because it may affect the final clinical outcome of patients.

Health Related Quality of Life, Anxiety and Depression among Tuberculosis Patients in Kathmandu, Nepal

“…Study of Uganda shows older men had lower HRQoL score where as women had higher HRQoL as similar to this study [9]. The health-related quality of life (HRQoL) of Tuberculosis (TB) patients of Yemen was similar to this study, HRQoL of measurement by SF-36 of 197 found that the mean PCS and MCS scores at the early treatment were low this is the poor health condition [10].…”

Evaluation of tuberculosis defaulters in Yemen from the perspective of health care service

“…Approximately 30.8% of defaulters reported stigmatization from society, friends and culture as their main reason for defaulting. A recent study also strongly related TB to stigmatization in Yemen . In Yemen, a TB infection creates numerous troubles in society due to stigmatization.…”

“…The results show that living in rural areas is a main risk factor associated with TB treatment defaulting. The majority of TB patients travel from rural areas to urban areas for proper diagnosis and treatment due to the shortage of laboratory and health facilities in rural areas . This high percentage of defaulters from rural areas can be due to the poor economic situation in these areas and the low education level of defaulters from these areas .…”

“…The majority of TB patients travel from rural areas to urban areas for proper diagnosis and treatment due to the shortage of laboratory and health facilities in rural areas. [8,18] This high percentage of defaulters from rural areas can be due to the poor economic situation in these areas and the low education level of defaulters from these areas. [19] Moreover, ignorance and naivety about the disease and the free medication provided by TB centres can also account for the increased defaulting rate in rural areas.…”

Untitled

“…HRQOL scoring was sensitive to changes in the quality of life of patients as demonstrated by statistically significant differences in physical and mental component scoring observed among the patients. Several studies reported that quality of life of patients with tuberculosis is negatively affected [12][13][14] .…”