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.
Objectives To identify the risk factors associated with patient non‐compliance to anti‐tuberculosis treatment among Yemini tuberculosis (TB) patients. Methods A prospective nested case‐control study was conducted. Non‐compliant cases were recruited from a cohort of TB patients registered between July 2007 and June 2008 in 10 governorates. Three forms were used for data collection that covered interviewing the participants and reviewing their medical cards and TB registers. Independent variables extracted from univariate logistic regression were analysed in multivariate regression to identify independent risk factors for non‐compliance. Results Descriptive statistics showed that approximately 90% of the respondents were at their most economically productive age (15–54 years; with mean (standard deviation) of 32.1 (± 13.6)). The response rate for the study was 87.8%. By the end of the follow‐up period a total of 133 cases were identified. A non‐compliance rate of 16.3% has been found. In the multivariate logistic regression analysis, factors that remained independently associated with non‐compliance were: place of residence, literacy, travelling time, waiting time, employment, living status, family support, stigma, khat chewing and patients' knowledge of TB. Conclusion Results, imply existence of human resource gaps and TB staff inadequately prepared to deal with complex issues of TB patients. This study suggests that reducing travelling and waiting times for TB patients may improve compliance rates. This may be achieved by expansion of directly observed treatment short‐course near to patients' homes and involving additional staff. Improved education for patients and offering free services for unemployed may also improve compliance.
Background: Delay in TB diagnosis can increase the financial burden of patients, especially those
Background: The economic burden of tuberculosis (TB) in Yemen is enormous. Little
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