Effects of comorbidities on quality of life in Filipino people with tuberculosis

Abstract

BACKGROUND: We investigated health-related quality of life (HrQoL) in Filipino people undergoing TB treatment, and whether HrQoL was negatively impacted by comorbidity with undernutrition, diabetes (DM) and anaemia.METHODS: Adult participants were enrolled in public facilities in Metro Manila (three sites) and Negros Occidental (two sites). Multivariate linear regression was used to model the four correlated domain scores from a WHOQOL-BREF questionnaire (physical, psychological, social, environmental). A forward-stepwise approach was used to select a final multivariable model with inclusion based on global tests of significance at P < 0.1.RESULTS: In 446 people on drug-susceptible TB treatment, DM and moderate/severe anaemia were not associated with HrQoL. After adjustment for age, sex, education, food insecurity, treatment adherence, inflammation, Category I or II TB treatment, treatment phase, current side effects and inhibited ability to work, moderate/severe undernutrition (body mass index < 17 kg/m2) was associated with lower HrQoL (P = 0.003) with reduced psychological (coefficient: −1.02, 95% CI −1.54 to −0.51), physical (−0.62, 95% CI −1.14 to −0.09) and environmental domain scores (−0.45, 95% CI −0.88 to −0.01). In 225 patients with known HIV status in Metro Manila, HIV was associated with modestly reduced HrQoL (P = 0.014).CONCLUSION: Nutritional status and food insecurity represent modifiable risk factors for poor HrQoL that may be alleviated through interventions.

Health-Related Quality of Life (HRQoL) of Patients with Tuberculosis: A Review

“…Studies have found that comorbidities such as undernutrition or diabetes mellitus (DM) impact the TB care cascade [ 76 , 77 ]. For other diseased conditions, comorbidities or concomitant treatment is prognostic of lower QoL scores, especially in the physical domain [ 48 ].…”

“…TB co-infection worsens the symptoms of HIV and advances the disease to the next stage, which can further deteriorate the HRQoL [ 70 ]. Additionally, studies have found that TB patients are negatively impacted by comorbidities such as undernutrition, diabetes mellitus (DM), anemia, or HIV infection [ 76 , 77 ].…”

“…Few studies [72] found similar scores in HRQoL domains between individuals that received antiretroviral therapy (ART) with ATT and those that received ATT only [69,72]. Studies have found that comorbidities such as undernutrition or diabetes mellitus (DM) impact the TB care cascade [76,77]. For other diseased conditions, comorbidities or concomitant treatment is prognostic of lower QoL scores, especially in the physical domain [48].…”

Correlates of quality of life among persons living with tuberculosis: A cross-sectional study

“…Majority of the PLWTB in this study were newly diagnosed PLWTB in the intensive phase (first 2 months) of their treatment. The intensive phase can be physically and socially excruciating for PLWTB receiving TB treatment for the first time thus could negatively affect their QOL [53]. Previous studies emphasise the relevance of social support to the ability of PLWTB to cope with the impact of TB on their lives [23,54,55] and faith-based or religious institutions play a key role in providing this social support to PLWTB globally [22].…”

A 360-Degree View: An Autobiographical Case Report

“…Those with a higher BMI (>18.5) showed a lower mortality rate compared to those with lower BMI [13]. By addressing nutrition as an important determinant of pathogenesis and outcome of TB treatment, the health-related quality of life can be improved [14]. The genetic component linked with the pathogenesis of TB is less studied but has been well reported by a study [15].…”