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Sianturi EI, Izzah Z, Huda K, Sada EM, Perwitasari DA, Mantiri SYY, Gunawan E. Determinants of quality of life among people with HIV and tuberculosis in an underserved area in Indonesia: a cross-sectional study. Pan Afr Med J 2023; 46:61. [PMID: 38282780 PMCID: PMC10822095 DOI: 10.11604/pamj.2023.46.61.41521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/21/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction human immunodeficiency virus (HIV) and tuberculosis (TB) remain global health problems and impose a substantial reduction in people´s quality of life (QoL). This study aimed to assess and compare the QoL in HIV and TB patients and factors associated with QoL between those groups. Methods a cross-sectional study was conducted at a hospital clinic in Jayapura, Indonesia, between December 2022 and March 2023. Those who were aged above 18 years, diagnosed with HIV or TB infection, have been taking HIV or TB medications for at least 3 months, and provided informed consent were eligible to participate. Patients´ QoL was measured using the Bahasa Indonesia version of a validated 26-item World Health Organization Quality of Life - Brief (WHOQOL-BREF) questionnaire. Results a total of 365 patients with HIV and 125 with TB were included. The majority of participants were Papuan (75.9%) and aged 20 - 65 years (92.9%). More than half of the participants were female (56.5%), employed (50.8%), married (65.5%), and had family support (64.9%). Education level and social support were predictors of poor physical health in the HIV group, while ethnicity was a predictor in the TB group. Patients´ age was associated with poor psychological health in HIV, whereas sex was the associated factor in TB patients. Ethnicity was the only predictor of poor social relationships in those with TB. Whereas patients´ age was a predictor of poor environmental health in the HIV group, marital status, and education were predictors in the TB group. Finally, only social support was associated with poor general QoL in TB patients. Conclusion tuberculosis (TB) patients had poorer QoL than those with HIV. There is a need for more awareness to support those receiving TB treatment. In addition, further research is needed to understand in more detail the determinants of patients with drug-resistant TB, TB with HIV, and drug-resistant TB-HIV, to ensure that interventions are designed to help them.
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Affiliation(s)
- Elfride Irawati Sianturi
- Pharmacy Department, Faculty of Mathematics and Natural Sciences, University of Cenderawasih, Papua, Indonesia
| | - Zamrotul Izzah
- Department of Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Khoirul Huda
- Pharmacy Department, Faculty of Mathematics and Natural Sciences, University of Cenderawasih, Papua, Indonesia
| | - Evelyn Magrid Sada
- Pharmacy Department, Faculty of Mathematics and Natural Sciences, University of Cenderawasih, Papua, Indonesia
| | | | | | - Elsye Gunawan
- Pharmacy Department, Faculty of Mathematics and Natural Sciences, University of Cenderawasih, Papua, Indonesia
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Khan FU, Khan FU, Aqeel MT, Hayat K, Chang J, Rehman AU, Fang Y. A randomized controlled trial to evaluate the impact of pharmacist-led clinical interventions on the health-related quality of life among TB patients. Front Pharmacol 2023; 14:1171985. [PMID: 37292150 PMCID: PMC10246751 DOI: 10.3389/fphar.2023.1171985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/03/2023] [Indexed: 06/10/2023] Open
Abstract
Background: The study was designed to evaluate the impact of pharmacist-led clinical interventions on the health-related quality of life among tuberculosis patients in Pakistan. Methods: A randomized, controlled prospective study was carried out in a Pakistan Institute of Medical Sciences hospital tuberculosis (TB) control center. Participants who visited the TB center between September 2020 and December 2021 were randomly assigned to two clusters, the usual care group (UC group) vs. the intervention group (pharmaceutical care group), in a 1:1 ratio by a simple envelope technique. In the intervention group, a patient received centered care that encompassed informed decision-making, which can increase the quality of care and monitoring of adverse drug events. However, the control group received routine TB treatment at the hospital. The EuroQol-5D-3L instrument was used to assess the health-related quality of life (HRQoL) at the baseline and in the third and sixth months of the treatment time period. Results: A total of 503 patients were eligible, of which only 426 patients were included in this study. At the end of the study, n = 205 of the patients in the intervention group and n = 185 of those in the control group were analyzed. In the intervention group, the EQ-5D-3L health utility score improved significantly (p < 0.001) (from the baseline mean ± SD, 0.40 ± 0.36, to 6 months of treatment, 0.89 ± 0.09, while in the control group from 0.42 ± 0.35 to 0.78 ± 0.27). In multivariate regression analysis, the variables that remained statistically associated (p < 0.001) with the HRQoL (unstandardized β [95% confidence interval]) of the control group were as follows: gender, female vs. male (-0.039 [-0.076 to -0.003]); body weight, less than 40 kg vs. more than 40 kg (-0.109 [-0.195 to -0.024]); patients with any comorbidity vs. without comorbidity (-0.136 [-0.252 to -0.020]); and smokers vs. non-smokers (-0.204 [-0.291 to -0.118]). The study did not find any statistically significant associations between the intervention group's variables and the HRQoL. Conclusion: Patient-centered care interventions led by pharmacists as part of care coordination enhanced the HRQoL for TB patients significantly. According to this study, clinical pharmacists should be included in the interdisciplinary clinical staff for TB patient management.
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Affiliation(s)
- Farman Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Xi’an, China
- Faculty of Pharmacy, Hamdard University Islamabad Campus, Islamabad, Pakistan
| | - Faiz Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Xi’an, China
| | | | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Xi’an, China
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Xi’an, China
| | - Asim ur Rehman
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Xi’an, China
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Jones-Patten A, Wang Q, Molebatsi K, Novotny TE, Siddiqi K, Modongo C, Zetola NM, Mbongwe B, Shin SS. Depression, Anxiety, and Cigarette Smoking Among Patients with Tuberculosis. Clin Nurs Res 2023; 32:22-28. [PMID: 36285635 PMCID: PMC9749560 DOI: 10.1177/10547738221132096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Smoking adversely affects tuberculosis (TB) outcomes and may be associated with depression and anxiety among people diagnosed with TB in Botswana. We conducted a cross-sectional study among patients newly diagnosed with TB in Gaborone, Botswana, evaluating factors associated with self-reported cigarette smoking. We performed Poisson regression analyses with robust variance to examine whether depressive and anxiety symptoms were associated with smoking. Among 180 participants with TB enrolled from primary health clinics, depressive symptoms were reported in 47 (26.1%) participants and anxiety symptoms were reported in 85 (47.2%) participants. Overall, 45 (25.0%) participants reported current smoking. Depressive symptoms were associated with a higher prevalence of smoking (adjusted prevalence ratio [aPR]: 2.04; 95% confidence interval [CI]: 1.29-3.25) in the adjusted analysis. The association between anxiety symptoms and smoking did not reach statistical significance (aPR: 1.26; 95% CI: 0.77-2.05). Future studies should further investigate these associations when addressing TB care.
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Affiliation(s)
| | - Qiao Wang
- University of California Los Angeles, CA, USA
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Quarcoopome L, Tornu E. Health-related quality of life of persons living with tuberculosis: A cross-sectional study. J Clin Tuberc Other Mycobact Dis 2022; 28:100324. [PMID: 35813286 PMCID: PMC9260615 DOI: 10.1016/j.jctube.2022.100324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Tuberculosis is a chronic infectious disease that can affect the quality of life of persons living with tuberculosis in resource-limited settings. There is a dearth of research on the quality of life of persons living with tuberculosis within Greater Accra, Ghana. Purpose This study investigated the quality of life and its related factors among persons living with tuberculosis in the Greater Accra region of Ghana. Methods This descriptive cross-sectional survey assessed the physical, psychological, social relationship and environmental quality of life of 250 persons living with tuberculosis in four public health facilities using the World Health Organization's Quality of Life Brief Questionnaire instrument. Results Respondents' mean (standard deviation) physical, psychological, social relationship and environmental health-related quality of life domain scores were 46.19 (21.27), 50.67 (23.95), 40.9 (21.74) and 51.91 (20.13) respectively out of 100. Sociodemographic factors which influenced all four quality of life domains were their marital and employment statuses. Respondents' site of TB infection (pulmonary or extrapulmonary) and phase of treatment influenced their physical, psychological and social domains. Other determinants of the quality of life were their sex, highest level of education and average monthly income. Conclusions The quality of life of persons living with tuberculosis was found to be poor and influenced by the patients' socioeconomic status. Strategies that identify and address any deterioration in the quality of life of persons living with TB are required throughout their management.
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Affiliation(s)
- Louisa Quarcoopome
- Department of Internal Medicine and Therapeutics, Korle-Bu Teaching Hospital, P.O.Box KB 77, Korle-Bu, Accra, Ghana
| | - Eric Tornu
- Department of Adult Health, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana
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Liu X, Bai X, Ren R, Tan L, Zhang Y, Lan H, Yang Q, He J, Tang X. Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: A cross-sectional study. Front Psychiatry 2022; 13:985823. [PMID: 36339832 PMCID: PMC9631205 DOI: 10.3389/fpsyt.2022.985823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/03/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Depression and anxiety are major psychological issues among patients with tuberculosis (TB) owing to chronic and complex treatments, have been reported to be closely correlated with immune and inflammation. However, the association of peripheral immune-inflammatory characteristics with depression/anxiety symptoms in in-patients with TB has rarely been reported. METHODS A cross-sectional study of 338 in-patients with TB from 3 hospitals in China were enrolled to investigate their depression and anxiety status by using the nine-item Patient Health Questionnaire (PHQ-9) and seven-item Generalized Anxiety Disorder Scale (GAD-7). Participants were divided into groups based on their PHQ-9 and GAD-7 scores, and differences in demography and immune-inflammatory characteristics were studied. Logistic analysis was performed to explore factors related to depression and anxiety symptoms. RESULTS Depression and anxiety prevalence among patients with TB was 47.9 and 42.6%, respectively. Furthermore, 38.5% of patients reported a comorbidity of depression and anxiety symptoms. The counts of CD3, CD4, CD8, and lymphocytes decreased, whereas those of neutrophils, platelets, and peripheral blood cells and their derived indices increased among TB patients with depression or anxiety in comparison with those without symptoms (p < 0.05). In addition, increasing age, lower income (monthly income ≤ 3,000 yuan), divorced or widowed, drug resistance, and higher systemic immune inflammation index (SII) were significantly associated with depression or anxiety symptoms (p < 0.05). CONCLUSION Approximately half of the patients with TB suffered from depression or/and anxiety symptoms. Patients with depression or anxiety present worse cell immune status and stronger inflammatory responses compared to those without symptoms. We emphasized the importance of paying attention to the dysfunction of immune-inflammation process of TB patients with depression or anxiety symptoms. Especially, SII has a potential application value in guiding the evaluation of TB-related depression or anxiety owing to its easily accessibility and being economical.
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Affiliation(s)
- Xiangmin Liu
- West China School of Nursing, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xinyu Bai
- West China School of Nursing, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Ren
- Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lu Tan
- Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ye Zhang
- Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Huizhen Lan
- Ward 3, Department of Tuberculosis, The Fourth People Hospital of Nanning, Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qianlan Yang
- West China School of Nursing, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jianqing He
- West China School of Nursing, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangdong Tang
- Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
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Sohail W. A 360-Degree View: An Autobiographical Case Report. Cureus 2021; 13:e20337. [PMID: 35036182 PMCID: PMC8752348 DOI: 10.7759/cureus.20337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 11/10/2022] Open
Abstract
The disease burden of tuberculosis (TB) has been declining in the developed world but the goal of eradicating TB seems like a daunting task in the developing regions. Patients with unrecognized TB or those receiving inappropriate treatment pose the greatest risk to the global burden of the disease. The aim of this article is to share the first-hand experience of a doctor, the author, contracting TB and the associated psychological impact. This change in role from a doctor to a patient came as an enlightening experience for the author and would give an insight into the psychological aspect when planning to find effective ways in the fight to eradicate TB.
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