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Shirasaki K, Hifumi T, Nakanishi N, Nosaka N, Miyamoto K, Komachi MH, Haruna J, Inoue S, Otani N. Postintensive care syndrome family: A comprehensive review. Acute Med Surg 2024; 11:e939. [PMID: 38476451 PMCID: PMC10928249 DOI: 10.1002/ams2.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
Families of critically ill patients are predisposed to tremendous burdens when their relatives are admitted to the intensive care unit (ICU). Postintensive care syndrome family (PICS-F) can be described as a devastated life, encompassing psychological, physical, and socioeconomical burdens that begin with the emotional impact experienced by the family when the patient is admitted to the ICU. PICS-F was primarily proposed as a clinically significant psychological impairment, but it needs to be extended beyond the psychological impairment of the family to include physical and socioeconomical impairments in the future. The prevalence of physiological problems including depression, anxiety and post-traumatic syndrome is 20-40%, and that of non-physiological problems including fatigue is 15% at 6 months after the ICU stay. Assessment of PICS-F was frequently conducted at 3- or 6-month points, although the beginning of the evaluation was based on different assessment points among each of the studies. Families of ICU patients need to be given and understand accurate information, such as the patient's diagnosis, planned care, and prognosis. Prevention of PICS-F requires a continuous bundle of multifaceted and/or multidisciplinary interventions including providing a family information leaflet, ICU diary, communication facilitators, supportive grief care, and follow-up, for the patient and families from during the ICU stay to after discharge from the ICU. This is the first comprehensive review of PICS-F to address the concept, risk factors, assessment tools, prevalence, and management to prevent PICS-F to facilitate acute care physicians' understanding of PICS-F.
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Affiliation(s)
- Kasumi Shirasaki
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Toru Hifumi
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Nobuto Nakanishi
- Division of Disaster and Emergency Medicine, Department of Surgery RelatedKobe University Graduate School of MedicineKobeJapan
| | - Nobuyuki Nosaka
- Department of Intensive Care MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Kyohei Miyamoto
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Miyuki H. Komachi
- School of Clinical Medicine, Department of Psychiatry, Child and Adolescent Resilience and Mental HealthUniversity of CambridgeCambridgeUK
| | - Junpei Haruna
- Department of Intensive Care Medicine, School of MedicineSapporo Medical UniversityHokkaidoJapan
| | - Shigeaki Inoue
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Norio Otani
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalTokyoJapan
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Ter Haar AM, Van den Hof M, Scherpbier HJ, Oostrom KJ, Haverman L, Pajkrt D. Health-related quality of life of perinatally HIV-infected young people: a longitudinal study. AIDS Care 2021; 34:263-271. [PMID: 33793369 DOI: 10.1080/09540121.2021.1909695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Young people perinatally infected with HIV (pHIV) are at risk of a lowered health-related quality of life (HRQOL). Previous evaluation of the NeurOlogical, VIsual and Cognitive performance in HIV-infected Children (NOVICE)-cohort showed no difference in HRQOL between pHIV and matched HIV-uninfected controls (HIV-), yet a higher percentage of pHIV had impaired HRQOL. The aim of this study is to compare the change over time in HRQOL of pHIV to HIV- over a 5-year period. We used the Pediatric Quality of Life Inventory (PedsQL)™ 4.0 to repeat HRQOL assessment. High PedsQL scores indicate good HRQOL. Fifteen/33 (45.5%) pHIV and 17/37 (45.9%) HIV- completed both assessments. At the first assessment, the mean age was 13.1 years (range 8.0-18.4). PHIV scored higher than HIV- on Emotional functioning and on Total scale score. After five years, the mean age was 17.6 years (range 12.1-22.8). PHIV scored higher than HIV- on all scales, except Social functioning. PHIV did not differ significantly from the Dutch norm on either time-point. LMEM showed no difference in change over time for any of the PedsQL scales. In this study, young people with pHIV receiving high-quality health care, including monitoring of HRQOL, remain to experience a good HRQOL.
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Affiliation(s)
- A M Ter Haar
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Pediatric Infectious Diseases, Amsterdam, Netherlands
| | - M Van den Hof
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Pediatric Infectious Diseases, Amsterdam, Netherlands
| | - H J Scherpbier
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Pediatric Infectious Diseases, Amsterdam, Netherlands
| | - K J Oostrom
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, Department of Child and Adolescent Psychiatry, Pediatric Psychology and Psychosocial Care, University of Amsterdam, Amsterdam, Netherlands
| | - L Haverman
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, Department of Child and Adolescent Psychiatry, Pediatric Psychology and Psychosocial Care, University of Amsterdam, Amsterdam, Netherlands
| | - D Pajkrt
- Emma Children's Hospital, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Pediatric Infectious Diseases, Amsterdam, Netherlands
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3
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Paul RH, Cho KS, Belden AC, Mellins CA, Malee KM, Robbins RN, Salminen LE, Kerr SJ, Adhikari B, Garcia-Egan PM, Sophonphan J, Aurpibul L, Thongpibul K, Kosalaraksa P, Kanjanavanit S, Ngampiyaskul C, Wongsawat J, Vonthanak S, Suwanlerk T, Valcour VG, Preston-Campbell RN, Bolzenious JD, Robb ML, Ananworanich J, Puthanakit T. Machine-learning classification of neurocognitive performance in children with perinatal HIV initiating de novo antiretroviral therapy. AIDS 2020; 34:737-748. [PMID: 31895148 PMCID: PMC7072001 DOI: 10.1097/qad.0000000000002471] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To develop a predictive model of neurocognitive trajectories in children with perinatal HIV (pHIV). DESIGN Machine learning analysis of baseline and longitudinal predictors derived from clinical measures utilized in pediatric HIV. METHODS Two hundred and eighty-five children (ages 2-14 years at baseline; Mage = 6.4 years) with pHIV in Southeast Asia underwent neurocognitive assessment at study enrollment and twice annually thereafter for an average of 5.4 years. Neurocognitive slopes were modeled to establish two subgroups [above (n = 145) and below average (n = 140) trajectories). Gradient-boosted multivariate regressions (GBM) with five-fold cross validation were conducted to examine baseline (pre-ART) and longitudinal predictive features derived from demographic, HIV disease, immune, mental health, and physical health indices (i.e. complete blood count [CBC]). RESULTS The baseline GBM established a classifier of neurocognitive group designation with an average AUC of 79% built from HIV disease severity and immune markers. GBM analysis of longitudinal predictors with and without interactions improved the average AUC to 87 and 90%, respectively. Mental health problems and hematocrit levels also emerged as salient features in the longitudinal models, with novel interactions between mental health problems and both CD4 cell count and hematocrit levels. Average AUCs derived from each GBM model were higher than results obtained using logistic regression. CONCLUSION Our findings support the feasibility of machine learning to identify children with pHIV at risk for suboptimal neurocognitive development. Results also suggest that interactions between HIV disease and mental health problems are early antecedents to neurocognitive difficulties in later childhood among youth with pHIV.
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Affiliation(s)
- Robert H Paul
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Missouri
| | - Kyu S Cho
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Missouri
| | - Andrew C Belden
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Missouri
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, and Columbia University, New York
| | - Kathleen M Malee
- Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, and Columbia University, New York
| | - Lauren E Salminen
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, California, USA
| | - Stephen J Kerr
- HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center
- Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Badri Adhikari
- Department of Mathematics and Computer Science, University of Missouri-St. Louis, Missouri, USA
| | - Paola M Garcia-Egan
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Missouri
| | - Jiratchaya Sophonphan
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, and Columbia University, New York
| | | | - Kulvadee Thongpibul
- Department of Psychology, Faculty of Humanities, Chiang Mai University, Chiang Mai
| | - Pope Kosalaraksa
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen
| | | | | | - Jurai Wongsawat
- Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand
| | | | - Tulathip Suwanlerk
- HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center
- TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
| | - Victor G Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California
| | | | - Jacob D Bolzenious
- Missouri Institute of Mental Health, University of Missouri-St. Louis, Missouri
| | - Merlin L Robb
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Jintanat Ananworanich
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- Department of Global Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Thanyawee Puthanakit
- HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Association between resilience, acute stress symptoms and characteristics of family members of patients at early admission to the intensive care unit. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.mhp.2018.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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5
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Malete L, Mokgatlhe L, Nnyepi M, Jackson J, Wen F, Bennink M, Anabwani G, Makhanda J, Thior I, Lyoka P, Weatherspoon L. Effects of a High Protein Food Supplement on Physical Activity, Motor Performance and Health Related Quality of Life of HIV Infected Botswana Children on Anti-Retroviral Therapy (ART). AIMS Public Health 2017; 4:258-277. [PMID: 29546216 PMCID: PMC5690453 DOI: 10.3934/publichealth.2017.3.258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/19/2017] [Indexed: 11/29/2022] Open
Abstract
Objective Despite existing evidence about the benefits of nutrition, physical activity (PA) and sport to the overall health and wellbeing of children, knowledge gaps remain on this relationship in children living with chronic conditions like HIV/AIDS. Such knowledge should inform context specific programs that could enhance the quality of life of children. The purpose of this study was to examine the effects of integrating a nutrition intervention (culturally tailored food supplement) into antiretroviral therapy (ART) on psychosocial outcomes and physical activity among HIV-positive children in Botswana. Method 201 HIV-positive children (6–15 years; M = 9.44, SD = 2.40) were recruited and randomly assigned (stratified by age and gender) to two groups. The intervention group (n = 97) received a high protein (bean-sorghum plus micronutrients) food supplement, while the control group (n = 104) received a sorghum plus micronutrients supplement. Participants were followed over 12 months. Anthropometric measures, PA, motor performance, and health related quality of life (HRQL) were collected at baseline, 6 and 12 months. Results Mixed repeated-measures ANOVA revealed a significant time effect of the food supplement on target variables except body fat percentage, speed, and school functioning. Time × treatment interaction was found for physical functioning, psychosocial functioning and total quality of life score. Scores on physical functioning and total of quality life in the intervention group significantly increased from baseline to 6 months compared with the control group (p = 0.015). Conclusion A combination of ART and nutritional intervention had a positive effect on physical functioning and total quality of life of HIV-positive children in this study. There were also improvements to physical activity and motor performance tests over time. More research is needed on long term effects of nutrition and PA interventions on HRQL in children living with HIV.
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Affiliation(s)
| | | | | | - Jose Jackson
- Michigan State University, East Lansing, Michigan, USA
| | - Fujun Wen
- Michigan State University, East Lansing, Michigan, USA
| | | | - Gabriel Anabwani
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.,Baylor College of Medicine, Pediatric Retrovirology, Houston, Texas, USA
| | - Jerry Makhanda
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana
| | - Ibou Thior
- Botswana Harvard Partnership, Gaborone, Botswana
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Cohen S, ter Stege JA, Weijsenfeld AM, van der Plas A, Kuijpers TW, Reiss P, Scherpbier HJ, Haverman L, Pajkrt D. Health-related quality of life in perinatally HIV-infected children in the Netherlands. AIDS Care 2015; 27:1279-88. [PMID: 26272357 DOI: 10.1080/09540121.2015.1050986] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Combination antiretroviral therapy (cART) can alter HIV infection in children into a chronic condition. Studies investigating health-related quality of life (HRQoL) in HIV-infected children are scarce, and lacking from Western Europe. This study aimed to compare the HRQoL of clinically stable perinatally HIV-infected children to healthy, socioeconomically (SES)-matched controls as well as the Dutch norm population, and to explore associations between HIV and cART-related factors with HRQoL. HIV-infected and healthy children aged 8-18 years completed the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™). We determined differences between groups on PedsQL™ mean scores, and the proportion of children with an impaired HRQoL per group (≥1 SD lower than the Dutch norm population). Logistic regression models were used to explore associations between disease-related factors and HRQoL impairment. In total, 33 HIV-infected and 37 healthy children were included. There were no differences in the mean PedsQL™ subscales between HIV-infected children and both control groups. The proportion of children with an impaired HRQoL was higher in the HIV-infected group (27%) as compared to the healthy control group (22%) and the Dutch norm (14%) on the school functioning subscale (HIV vs. Dutch norm: P = .045). Mean scores of HRQoL of perinatally HIV-infected children in the Netherlands were not different from a SES-matched control group, or from the Dutch norm population. However, the HIV-infected group did contain more children with HRQoL impairment, suggesting that HIV-infected children in the Netherlands are still more vulnerable to a compromised HRQoL.
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Affiliation(s)
- Sophie Cohen
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Jacqueline A ter Stege
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.,b Psychosocial Department , Emma Children's Hospital, Academic Medical Center , The Netherlands
| | - Annouschka M Weijsenfeld
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Atie van der Plas
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Taco W Kuijpers
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Peter Reiss
- c Department of Internal Medicine, Division of Infectious Diseases , Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center , Amsterdam , The Netherlands.,d Department of Global Health , Academic Medical Center, University of Amsterdam, and Amsterdam Institute of Global Health and Development , Amsterdam , The Netherlands.,e Amsterdam Institute of Global Health and Development , Amsterdam , The Netherlands.,f HIV Monitoring Foundation , Amsterdam , The Netherlands
| | - Henriette J Scherpbier
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Lotte Haverman
- b Psychosocial Department , Emma Children's Hospital, Academic Medical Center , The Netherlands
| | - Dasja Pajkrt
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
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Bunupuradah T, Panthong A, Kosalaraksa P, Wongsabut J, Puthanakit T, Lumbiganon P, Chuanjaroen T, Sopharak C, Udompanit T, Prasitsuebsai W, Pancharoen C, Ananworanich J. Simplifying antiretroviral therapy to lopinavir/ritonavir monotherapy did not improve quality of life and therapy adherence in pretreated HIV-infected children. AIDS Res Hum Retroviruses 2014; 30:260-5. [PMID: 24274723 DOI: 10.1089/aid.2013.0204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
We reported quality of life (QOL) and adherence in HIV-infected children after simplifying the antiretroviral regimen by switching to lopinavir/ritonavir monotherapy (mLPV/r). HIV-infected children with HIV-RNA <50 copies/ml while using second-line double boosted protease inhibitors were switched to mLPV/r. Primary caregivers completed PACTG QOL questionnaires at weeks 0, 48, 96, and 144. Adherence by pill count was performed at every visit. Thirty-eight pretreated HIV-infected Thai children were enrolled. The median (IQR) age was 11.5 (10.2-13.2) years and 53% were female. At enrollment, 34 used LPV/r+saquinavir and four used LPV/r+indinavir. The median (IQR) CD4% was 27 (23-30)%. At week 144, QOL scores were similar to baseline for all domains. A transient increase in the symptoms domain score was seen at week 96 (p=0.01), whereas the physical resilience domain score was decreased at weeks 48 and 96 (both p<0.05). Despite the mean number of pills decreasing from 7.9 pills/day before and 3.7 pills/day after mLPV/r (p<0.001), there were no differences over time in adherence rates by pill count and proportion of children with poor adherence (all p>0.05). Our study did not demonstrate improvement of QOL scores and adherence rates by pill count in pretreated HIV-infected children after simplification of the antiretroviral regimen to lopinavir/ritonavir monotherapy.
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Affiliation(s)
- Torsak Bunupuradah
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Apirudee Panthong
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | - Jiratchaya Wongsabut
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Thanyawee Puthanakit
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Department of Pediatrics, Chulalongkorn University, Bangkok, Thailand
| | | | - Thongsuai Chuanjaroen
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | | | - Wasana Prasitsuebsai
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | - Jintanat Ananworanich
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Department of Medicine, Chulalongkorn University, Bangkok, Thailand
- SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
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Bunupuradah T, Kosalaraksa P, Vibol U, Hansudewechakul R, Sophonphan J, Kanjanavanit S, Ngampiyaskul C, Wongsawat J, Luesomboon W, Vonthanak S, Ananworanich J, Ruxrungtham K, Puthanakit, on behalf of the PREDIC T. Impact of antiretroviral therapy on quality of life in HIV-infected Southeast Asian children in the PREDICT study. AIDS Patient Care STDS 2013; 27:596-603. [PMID: 24191673 DOI: 10.1089/apc.2013.0203] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Quality of life (QOL) is an important antiretroviral treatment (ART) outcome. We compared QOL among 299 Thai and Cambodian children ages 1-12 years-old, CD4 15-24% randomized to early (ART at week 0, N=149) versus deferred groups (ART when at CD4 <15%, N=150) and also compared with QOL data from age-matched healthy controls (N=275). Primary caregivers completed PACTG QOL questionnaires at week 0 and every 24 weeks until 144 weeks. Children were enrolled during March 2006 to September 2008. Mean (SD) age of children was 6.3 (2.8) years, 58% were female, 60% were Thai, %CDC N:A:B:C was 2:62:36:0%. During 144 weeks, all children in the early-group and 69 (46%) of deferred-group children started ART. There was no significant difference of QOL scores between treatment groups at baseline (all p>0.05) and at week 144 (all p>0.05). By multivariate analysis, the early-group had higher QOL score changes in five domains, including health perception (p=0.04), physical resilience (p=0.02), psychosocial well-being (p=0.04), social and role functioning (p<0.01), and symptoms (p=0.01) compared to the deferred group. QOL of HIV-infected children in both groups were lower than healthy control in all 7 domains at baseline (all p<0.05) and 5 of 7 domains at weeks 144 (p<0.01). In conclusion, no significant difference of QOL scores between treatment groups. Early ART commencement associated with greater increase of QOL scores over 144 weeks. QOL scores in HIV-infected children were lower than healthy controls.
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Affiliation(s)
- Torsak Bunupuradah
- HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | | | - Ung Vibol
- National Center for HIV/AIDS, Dermatology and STDs (NCHADS), Phnom Penh, Cambodia
| | | | - Jiratchaya Sophonphan
- HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | | | | | - Jurai Wongsawat
- Bamrasnaradura Infectious Disease Institute, Nonthaburi, Thailand
| | | | - Saphonn Vonthanak
- National Center for HIV/AIDS, Dermatology and STDs (NCHADS), Phnom Penh, Cambodia
| | - Jintanat Ananworanich
- HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center, Bangkok, Thailand
- SEARCH, Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kiat Ruxrungtham
- HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanyawee Puthanakit, on behalf of the PREDIC
- HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Department of Pediatrics, Chulalongkorn University, Bangkok, Thailand
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Mabugu T, Revill P, van den Berg B. The Methodological Challenges for the Estimation of Quality of Life in Children for Use in Economic Evaluation in Low-Income Countries. Value Health Reg Issues 2013; 2:231-239. [PMID: 29702870 DOI: 10.1016/j.vhri.2013.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The assessment of quality of life (QOL) in children has been underresearched in high- and low-income countries alike. This is partly due to practical and methodological challenges in characterizing and assessing children's QOL. This article explores these challenges and highlights considerations in developing age-specific instruments for children affected by HIV and other health conditions in Africa and other low-income settings. METHODS A literature search identified works that have 1) developed, 2) derived utilities for, or 3) applied QOL tools for use in economic evaluations of HIV interventions for children. We analyzed the existing tools specifically in terms of domains considered, variations in age bands, the recommended respondents, and the relevance of the tools to African and also other low-income country contexts. RESULTS Only limited QOL research has been conducted in low-income settings on either adults or children with HIV. A few studies have developed and applied tools for children (e.g., in Thailand, Brazil, and India), but none have been in Africa. The existing methodological literature is inconclusive on the appropriate width or depth by which to define pediatric QOL. The existing instruments include QOL domains such as "physical functioning," "emotional and cognitive functioning," "general behavior (social, school, home)," "health perception," "coping and adaptation," "pain and discomfort," "extended effects," "life perspective," and "autonomy." CONCLUSIONS QOL assessment in children presents a series of practical and methodological challenges. Its application in low-income settings requires careful consideration of a number of context-specific factors.
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Affiliation(s)
- Travor Mabugu
- Clinical Research Centre, University of Zimbabwe, Harare, Zimbabwe.
| | - Paul Revill
- Centre for Health Economics, University of York, York, UK
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