| dc.description.abstract | Introduction: By the end of 2020, there were approximately 155 million TB survivors globally. TB survivors have up to three times increased risk of mortality from post-Pulmonary TB lung complications compared with the general population, with a prevalence of lung impairment between 18% and 87%. Currently, health systems, especially in Africa, do not recognize that TB care extends beyond treating the initial infection, which leaves the majority of survivors at a higher risk of both clinical and socio-economic consequences even after a microbiologic cure of TB. In Uganda, the burden of post-PTB lung disease, and the health and well-being of TB survivors is poorly understood partly because of a lack of literature, and this contributes to poor health service provision in this sub-population
Objectives: The study intended to determine the health-related quality of life of post-PTB lung disease patients and their associated factors in Mulago National Referral Hospital from 1st May 2022 to 31st May 2023.
Methods: This study employed a cross-sectional design and utilized quantitative methods to determine the proportion of post-PTLD patients among the general patient population attending the chest clinic at MNRH, their clinical patterns using patient files, their health-related quality of life (HRQOL) (Physical and Mental composite domains) using the SF36v2 questionnaire, and factors associated with HRQOL among these patients. For the post-PTB lung disease patients who met the eligibility criteria and were sampled, interviewer-administered questionnaires were used to collect quantitative data. Before data collection, informed consent was obtained to confirm participants’ willingness to participate in the study. Data was entered into Ms. Excel and analysed using STATA software version 16.
Study findings: One hundred thirty-three patients with post-PTLD lung disease were included in the study. Post-PTLD lung disease accounted for almost 16 % (173/1086) of the patients who attended the chest clinic.
The mean physical composite score (PCS) among post-PTLD patients for this study was 54.8 units while the mean mental composite score (MCS) was 57.3units
Factors associated with an increase in mean values of PCS included monthly income between (54 and 134 USD) (ARC=7.35, p-value=0.009) and more than 134 USD (ARC=11.91, p-value<0.001), having family support during treatment (ARC=11.40, p-value=0.002), and receiving counselling (ARC=8.39, p-value=0.001). Age of at least 50 years (ARC=-8.7, p-value=0.028), COPD (ARC=--10.82, p-value<0.001), drinking alcohol (ARC=--9.04, p-value=0.003), being self-employed (ARC=-7.43, p-value =0.023) and smoking (ARC=-7.29, p-value=0.048) were associated with a decrease in the mean scores of MCS
Conclusions: The mean scores of physical and mental components of health-related quality of life were generally fair. There was a strong positive correlation between the physical component score and the mental component score. Monthly income greater than 54 USD (Ushs.150, 000) having family support during treatment, and receiving counselling were significantly associated with increased mean values of PCS. Age of at least 50 years, having COPD, drinking alcohol, and smoking significantly decreased the mean scores of MCS.
Recommendations:
The study recommends that the care of pulmonary tuberculosis should not be limited to the treatment of initial infection with anti-tuberculous medications. Clinicians should actively screen PTB survivors at risk of developing post-PTB lung complications (diseases) and offer appropriate care at the earliest time of contact to improve their health-related quality of life. Clinicians should emphasize the importance of quitting alcohol consumption and smoking by patients with post-PTLD. Patients with post-PTLD who smoke or consume alcohol should further be prioritized for rehabilitation and equipped with copying mechanisms to modify these risky practices. | en_US |
