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Quality of life and associated factors among patients with tuberculosis at the University of Gondar comprehensive specialized hospital, Ethiopia

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Abstract

Purpose

Clinical outcomes have failed to capture the impact of tuberculosis (TB) on patients; consequently, a comprehensive measure is required. This study’s objective was to determine the level of quality of life (QOL) and associated factors among patients with TB at the University of Gondar comprehensive specialized hospital, TB clinic.

Methods

A cross-sectional study was conducted from April to June 2019. A total of 400 patients were selected. The world health organization quality-of-life (WHOQOL-Bref) questionnaire was used to measure QOL. Linear regression analysis was done to investigate potential predictors, and variables with a P value of <0.05 were considered statistically significant.

Results

The participants had a mean age of 38.04 ± 13.53 years; the percentage of patients with pulmonary TB (PTB) was 52.71% and 57.36% were male. The QOL scores for physical, psychological, social and environmental domains were 43.54 ± 10.18, 46.67 ± 7.93, 39.79 ± 15.30 and 41.22 ± 12.90, respectively. PTB was associated with physical, psychological, social, and environmental domains (B = −3.99, P value <0.001), (B = −2.03, P value = 0.027), (B = −4.44, P value = 0.008), and (B = −2.83, P value = 0.029), individually; likewise, drug adherence was associated with physical (B = −10.36), psychological (B = −4.48), social (B = −14.46), and environmental (B = −8.44) domains at a P value <0.001. Education (B = 2.39, P value = 0.018), and co-morbidity (B = −4.28, P value = 0.023) were associated with the psychological domain. Finally, occupation was significantly associated with the environmental domain (B = −4.53, P value = 0.008).

Conclusion

This study revealed that the QOL of patients was relatively low compared to that of other studies. Notably, social domains were affected more than other domains. Non-adherence and PTB were negatively associated with all domains. Therefore, health professionals should emphasize patients’ drug adherence.

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Availability of data and material

The datasets supporting the conclusions of this article are available upon request to the corresponding author. Due to data protection restrictions and participant confidentiality, we do not make participants’ data publicly available.

References

  1. Kyu, H. H., Maddison, E. R., Henry, N. J., Ledesma, J. R., Wiens, K. E., Reiner, R., Jr., et al. (2018). Global, regional, and national burden of tuberculosis, 1990–2016: Results from the global burden of diseases, injuries, and risk factors 2016 study. The Lancet Infectious Diseases, 18(12), 1329–1349.

    Article  Google Scholar 

  2. Deribew, A., Deribe, K., Dejene, T., Tessema, G. A., Melaku, Y. A., Lakew, Y., et al. (2018). Tuberculosis burden in Ethiopia from 1990 to 2016: Evidence from the global burden of diseases 2016 study. Ethiopian Journal of Health Sciences, 28(5).

  3. Minister of Health. (2018). Guidelines for management of tb, dr-tb and leprosyin ethiopia. https://www.afro.who.int/publications/national-guidelines-tb-drug-resistant-tb-and-leprosy-ethiopia-sixth-edition

  4. Asres, A., Jerene, D., & Deressa, W. (2018). Pre-and post-diagnosis costs of tuberculosis to patients on directly observed treatment short course in districts of southwestern Ethiopia: A longitudinal study. Journal of Health, Population and Nutrition, 37(1), –15.

  5. United Nation Development Programme (UNDP). (2016). Sustainable Development Goals (SDGs). https://www.undp.org/content/dam/undp/library/corporate/brochure/SDGs_Booklet_Web_En.pdf

  6. United Nations Development Programme (UNDP). (2000). Millennium Development Goals (MDGs). https://www.undp.org/content/undp/en/home/sdgoverview/mdg_goals.html

  7. Dye, C., Garnett, G. P., Sleeman, K., & Williams, B. G. (1998). Prospects for worldwide tuberculosis control under the WHO DOTS strategy. The Lancet, 352(9144), 1886–1891.

    Article  CAS  Google Scholar 

  8. WHO. (2016). Implementing the end TB strategy: The essentials. https://www.who.int/tb/publications/2015/The_Essentials_to_End_TB/en/

  9. Aggarwal, A. N. (2010). Health-related quality of life: A neglected aspect of pulmonary tuberculosis. Lung India: Official Organ of Indian Chest Society, 27(1), 1.

    Article  Google Scholar 

  10. Kastien-Hilka, T., Abulfathi, A., Rosenkranz, B., Bennett, B., Schwenkglenks, M., & Sinanovic, E. (2016). Health-related quality of life and its association with medication adherence in active pulmonary tuberculosis – A systematic review of global literature with focus on South Africa. Health and Quality of Life Outcomes, 14(1), 42.

    Article  Google Scholar 

  11. World Health Organization. (1996). WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment: Field trial version, December 1996.

  12. Revicki, D. A., Osoba, D., Fairclough, D., Barofsky, I., Berzon, R., Leidy, N., et al. (2000). Recommendations on health-related quality of life research to support labeling and promotional claims in the United States. Quality of Life Research, 9(8), 887–900.

    Article  CAS  Google Scholar 

  13. Sajid, M., Tonsi, A., & Baig, M. (2008). Health-related quality of life measurement. International Journal of Health Care Quality Assurance, 21, 365–373. https://doi.org/10.1108/09526860810880162.

    Article  CAS  PubMed  Google Scholar 

  14. Verster, J. C., Pandi-Perumal, S. R., & Streiner, D. L. (2008). Sleep and quality of life in clinical medicine. Springer.

  15. Aggarwal, A. N. (2010). Health-related quality of life: A neglected aspect of pulmonary tuberculosis. Lung India : Official Organ of Indian Chest Society, 27(1), 1–3. https://doi.org/10.4103/0970-2113.59259.

    Article  Google Scholar 

  16. Chamla, D. (2004). The assessment of patients' health-related quality of life during tuberculosis treatment in Wuhan, China. The International Journal of Tuberculosis and Lung Disease, 8(9), 1100–1106.

    CAS  PubMed  Google Scholar 

  17. Salma, S., Siddiqua, A. A., Keerthana, R. L., Suryadevara, M., Prabhakar, D. V., & Pingili, R. (2019). Assessment of medication adherence, quality of life and risk factors among patients with tuberculosis in a south Indian tertiary care hospital: A cross-sectional study. International Journal, 5(8), 213.

    Google Scholar 

  18. Dhuria, M., Sharma, N., Singh, N. P., Jiloha, R. C., Saha, R., & Ingle, G. K. (2009). A study of the impact of tuberculosis on the quality of life and the effect after treatment with DOTS. Asia Pacific Journal of Public Health, 21(3), 312–320.

    Article  Google Scholar 

  19. Deribew, A., Tesfaye, M., Hailmichael, Y., Negussu, N., Daba, S., Wogi, A., et al. (2009). Tuberculosis and HIV co-infection: Its impact on quality of life. Health and Quality of Life Outcomes, 7(1), 105.

    Article  Google Scholar 

  20. Salehitali, S., Noorian, K., Hafizi, M., & Dehkordi, A. H. (2019). Quality of life and its effective factors in tuberculosis patients receiving directly observed treatment short-course (DOTS). Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 15, 100093.

    Article  Google Scholar 

  21. Malik, M., Nasir, R., & Hussain, A. (2018). Health related quality of life among TB patients: Question mark on performance of TB DOTS in Pakistan. Journal of Tropical Medicine, 2018.

  22. Sule, A. G., Odeigah, L. O., Alabi, K. M., Issa, B. A., Shittu, R. O., Joseph, A. I., et al. (2014). Quality of life of patients with tuberculosis in a Nigerian teaching hospital. anxiety, 12(13), 14.

    Google Scholar 

  23. Ethiopian Ministry of Health. (2012). Guidelines for clinical and programmatic management of TB, Leprosy and TB/HIV in Ethiopia. http://www.who.int/hiv/pub/guidelines/ethiopia_tb.pdf

  24. MoH. (2014). National strategic plan tuberculosis and leprosy control. https://www.afro.who.int/sites/default/files/2019-04/Ethiopia%20-%20National%20Strategic%20Plan%20Tuberculosis%20and%20Leprosy%20Control%202013-2020.pdf

  25. Eshetie, S., Gizachew, M., Alebel, A., & van Soolingen, D. (2018). Tuberculosis treatment outcomes in Ethiopia from 2003 to 2016, and impact of HIV co-infection and prior drug exposure: A systematic review and meta-analysis. PLoS One, 13(3).

  26. Alene, K. A., Viney, K., Gray, D. J., McBryde, E. S., Wagnew, M., & Clements, A. C. A. (2019). Mapping tuberculosis treatment outcomes in Ethiopia. BMC Infectious Diseases, 19(1), 474. https://doi.org/10.1186/s12879-019-4099-8.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Deribew, A., Deribe, K., Reda, A. A., Tesfaye, M., Hailmichael, Y., Maja, T., et al. (2013). Change in quality of life: A follow up study among patients with HIV infection with and without TB in Ethiopia. BMC Public Health, 13(1), 408.

    Article  Google Scholar 

  28. Organization, W. H. (1996). WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment: Field trial version, December 1996. Geneva: World Health Organization.

    Google Scholar 

  29. Aschalew, A. Y., Yitayal, M., & Minyihun, A. (2020). Health-related quality of life and associated factors among patients with diabetes mellitus at the University of Gondar referral hospital. Health and Quality of Life Outcomes, 18(1), 1–8.

    Article  Google Scholar 

  30. Araya, M., Chotai, J., Komproe, I. H., & de Jong, J. T. (2007). Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians. Quality of Life Research, 16(6), 915–927.

    Article  Google Scholar 

  31. Mousley, E., Deribe, K., Tamiru, A., & Davey, G. (2013). The impact of podoconiosis on quality of life in Northern Ethiopia. Health and Quality of Life Outcomes, 11(1), 122.

    Article  Google Scholar 

  32. Reba, K., Birhane, B. W., & Gutema, H. (2019). Validity and reliability of the Amharic version of the World Health Organization’s quality of life questionnaire (WHOQOL-BREF) in patients with diagnosed type 2 diabetes in Felege Hiwot referral hospital, Ethiopia. Journal of Diabetes Research, 2019.

  33. Woimo, T. T., Yimer, W. K., Bati, T., & Gesesew, H. A. (2017). The prevalence and factors associated for anti-tuberculosis treatment non-adherence among pulmonary tuberculosis patients in public health care facilities in South Ethiopia: A cross-sectional study. BMC Public Health, 17(1), 269.

    Article  Google Scholar 

  34. Mekonnen, H. S., & Azagew, A. W. (2018). Non-adherence to anti-tuberculosis treatment, reasons and associated factors among TB patients attending at Gondar town health centers, Northwest Ethiopia. BMC Research Notes, 11(1), 691.

    Article  Google Scholar 

  35. Central Statistical Agency (CSA) [Ethiopia] and ICF. (2016). Ethiopia demographic and health survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF.

  36. Vyas, S., & Kumaranayake, L. (2006). Constructing socio-economic status indices: How to use principal components analysis. Health Policy and Planning, 21(6), 459–468.

    Article  Google Scholar 

  37. Duko, B., Bedaso, A., Ayano, G., & Yohannis, Z. (2019). Perceived stigma and associated factors among patient with tuberculosis, Wolaita Sodo, Ethiopia: Cross-sectional study. Tuberculosis Research and Treatment, 2019, 5917537. https://doi.org/10.1155/2019/5917537.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Hansel, N. N., Wu, A. W., Chang, B., & Diette, G. B. (2004). Quality of life in tuberculosis: Patient and provider perspectives. Quality of Life Research, 13(3), 639–652.

    Article  Google Scholar 

  39. Long, N. H., Johansson, E., Diwan, V. K., & Winkvist, A. (2001). Fear and social isolation as consequences of tuberculosis in VietNam: A gender analysis. Health Policy, 58(1), 69–81.

    Article  CAS  Google Scholar 

  40. Oguzturk, O. (2008). Differences in quality of life in rural and urban populations. Clinical and Investigative Medicine, E346–E350.

  41. Atif, M., Sulaiman, S. A. S., Shafie, A. A., Asif, M., Sarfraz, M. K., & Low, H. C. (2014). Impact of tuberculosis treatment on health-related quality of life of pulmonary tuberculosis patients: A follow-up study. Health and Quality of Life Outcomes, 12(1), 19.

    Article  Google Scholar 

  42. Li, C.-T., Chu, K.-H., Reiher, B., Kienene, T., & Chien, L.-Y. (2017). Evaluation of health-related quality of life in patients with tuberculosis who completed treatment in Kiribati. Journal of International Medical Research, 45(2), 610–620.

    Article  Google Scholar 

  43. Louw, J. S., Mabaso, M., & Peltzer, K. (2016). Change in health-related quality of life among pulmonary tuberculosis patients at primary health care settings in South Africa: A prospective cohort study. PLoS One, 11(5), e0151892.

    Article  Google Scholar 

  44. Sartika, I., Insani, W. N., & Abdulah, R. (2019). Assessment of health-related quality of life among tuberculosis patients in a public primary care facility in Indonesia. Journal of Global Infectious Diseases, 11(3), 102.

    Article  Google Scholar 

  45. Bauer, M., Ahmed, S., Benedetti, A., Greenaway, C., Lalli, M., Leavens, A., et al. (2015). Health-related quality of life and tuberculosis: A longitudinal cohort study. Health and Quality of Life Outcomes, 13(1), 65.

    Article  Google Scholar 

  46. Masumoto, S., Yamamoto, T., Ohkado, A., Yoshimatsu, S., Querri, A. G., & Kamiya, Y. (2014). Factors associated with health-related quality of life among pulmonary tuberculosis patients in Manila, the Philippines. Quality of Life Research, 23(5), 1523–1533.

    Article  Google Scholar 

  47. Maguire, G., Anstey, N. M., Ardian, M., Waramori, G., Tjitra, E., Kenangalem, E., et al. (2009). Pulmonary tuberculosis, impaired lung function, disability and quality of life in a high-burden setting. The International Journal of Tuberculosis and Lung Disease, 13(12), 1500–1506.

    CAS  PubMed  Google Scholar 

  48. Dhingra, V., & Rajpal, S. (2005). Health related quality of life (HRQL) scoring (DR-12 score) in tuberculosis – Additional evaluative tool under DOTS. The Journal of Communicable Diseases, 37(4), 261–268.

    CAS  PubMed  Google Scholar 

  49. Chirwa, T., Nyasulu, P., Chirwa, E., Ketlogetswe, A., Bello, G., Dambe, I., et al. (2013). Levels of tuberculosis treatment adherence among sputum smear positive pulmonary tuberculosis patients attending care at Zomba central hospital, southern Malawi, 2007–2008. PLoS One, 8(5), e63050.

    Article  CAS  Google Scholar 

  50. Louw, J. S., Mabaso, M., & Peltzer, K. (2016). Change in health-related quality of life among pulmonary tuberculosis patients at primary health care settings in South Africa: A prospective cohort study. PLoS One, 11(5).

  51. Jaber, A. A. S., Khan, A. H., Sulaiman, S. A. S., Ahmad, N., & Anaam, M. S. (2016). Evaluation of health-related quality of life among tuberculosis patients in two cities in Yemen. PLoS One, 11(6).

  52. Louw, J., Peltzer, K., Naidoo, P., Matseke, G., Mchunu, G., & Tutshana, B. (2012). Quality of life among tuberculosis (TB), TB retreatment and/or TB-HIV co-infected primary public health care patients in three districts in South Africa. Health and Quality of Life Outcomes, 10(1), 77.

    Article  Google Scholar 

  53. Asres, A., Jerene, D., & Deressa, W. (2018). Pre- and post-diagnosis costs of tuberculosis to patients on directly observed treatment short course in districts of southwestern Ethiopia: A longitudinal study. Journal of Health, Population and Nutrition, 37(1), 15. https://doi.org/10.1186/s41043-018-0146-0.

    Article  Google Scholar 

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Acknowledgements

We are very thankful to the University of Gondar for the approval of the ethical issue and its technical support. We forward our appreciation to the hospital managers for allowing us to conduct this research and their cooperation. Finally, we would like to thank study participants for their volunteer participation and also data collectors and supervisors for their genuineness and quality of work during data collection.

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Authors and Affiliations

  1. University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia

    Alemayehu Dires

  2. Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

    Tsega Hagos, Mezgebu Yitayal, Getasew Amare & Andualem Yalew Aschalew

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  1. Alemayehu Dires
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  2. Tsega Hagos
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  3. Mezgebu Yitayal
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Correspondence to Andualem Yalew Aschalew.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was conducted after ethical approval was obtained from the Ethical Review Board of the Institute of Public Health, College of Medicine and Health Science, University of Gondar (Ref. No.: IPH/185/2019). Permission letters were obtained from the University of Gondar comprehensive specialized hospital. All study participants were oriented on the objectives and purpose of the study before study participation. Confidentiality and anonymity were explained. Patients at health facilities and sick individuals were informed that participation had no impact on the provision of their health care. Written informed consent was obtained, and study team members safeguarded the confidentiality and anonymity of study participants throughout the entire study. In order to protect the identities of the study participants, each participant was given a unique identification number (ID). Participation in the study was voluntary, and individuals were free to withdraw or stop the interview at any time.

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Written informed consent was obtained for all individual participants included in the study.

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Dires, A., Hagos, T., Yitayal, M. et al. Quality of life and associated factors among patients with tuberculosis at the University of Gondar comprehensive specialized hospital, Ethiopia. Qual Life Res 30, 1173–1181 (2021). https://doi.org/10.1007/s11136-020-02717-w

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