Factors associated with quality of life in patients with Chagas disease: SaMi-Trop project

Abstract

Chagas disease (CD) is a neglected tropical disease and its main consequence is chronic chagasic cardiomyopathy (CCC). The clinical manifestations of CD can cause functional limitation and impact on the perception of quality of life (QoL). We evaluated the QoL profile of patients with CD living in remote regions, and their association with socio-demographic, behavioral, and clinical characteristics.A cross-sectional study, using the baseline of a cohort study (SaMi-Trop) was conducted in the state of Minas Gerais, Brazil, an endemic region for CD. The cohort is composed of 1959 patients with CD. The patients were interviewed, and blood collection and electrocardiogram (ECG) were performed. The WHO-QOL-BREF scale was used to assess QoL. Descriptive statistics were performed and, for the QoL scale, measures of central tendency and dispersion were calculated. Inflated beta regression models constructed using the gamlss framework were used, and fitted using R software. A significance level of 5% for all analyzes was adopted.QoL was evaluated in 625 participants. The Environment (57.66) and Social Relationships (73.17) domains presented the lowest and highest QoL score respectively. There was no statistically significant difference between QoL domains in the presence of CCC. In the multivariate analysis, the factors associated with a lower QoL were in the Physical domain age increase (OR: 0.95, CI: 0.91-0.99) and using an angiotensin converting enzyme inhibitor (OR 0.89; CI: 0.80-0.99); in the Social Relations domain a history of acute myocardial infarction (OR: 0.75; CI: 0.61-0.92); and in the Environment domain age increase (OR 0.94, CI 0.91-0.97). The factor associated with higher QoL was the use of angiotensin receptor blockers (OR: 1.15; CI 1.04-1.26).The findings of this study reinforce the importance of QoL indicators for planning care and clinical management of patients from remote regions with CD.

Quality of Life Assessment Among Patients Living With Hepatosplenic Schistosomiasis and Schistosomal Myeloradiculopathy

“…The WHOQOL-BREF contains 26 questions, with two questions referring to the overall quality of life and the remaining questions related to physical, psychological, social and environmental domains (12). The Portuguese language version of WHOQOL-BREF has been validated and is widely used in Brazil as an appropriate tool to measure HRQOL in clinical settings (29)(30)(31)(32)(33).…”

Cohort profile update: the main and new findings from the SaMi-Trop Chagas cohort

“…There was an improvement in most quality of life domains. Better quality of life and clinical characteristics were associated with better medical care and treatment of ChD 20 .Thirteen percent of participants presented LV systolic dysfunction according to the ECHO findings.…”

“…The ECHO was not performed in the baseline. Two new groups of questions were included in the questionnaire: a set of questions regarding the use of health services, and the SALPHA instrument to evaluate the health literacy 20 . The death certificates of participants who died before FU1 were obtained from the local health system.…”

Quality of life in patients with Chagas disease and the instrument used: an integrative review

“…A similar result was found in the study by Quintino et al . 42 , in which the Environment domain was the one that influenced the most a lower perception of QoL.…”

“…Thus, further cost-effectiveness studies are needed in order to clarify the clinical and economic feasibility for incorporating these interventions into clinical practice. It is known that research in this area can contribute to the organization and provision of health care and the implementation of actions and clinical strategies that influence all domains of QoL in patients with CD 42 , 43 .…”