Socio-demographic and clinical determinants of quality of life among tuberculosis patients in Ghana: A prospective cohort study

Abstract

Abstract Background Tuberculosis affects patients' health-related quality of life because of its symptoms, prolonged duration of treatment and associated stigma. By identifying patients at greater risk of poor quality of life, interventional measures could be implemented to improve the health-related quality of life, medication adherence rates and treatment success for holistic patient care. Therefore, this study aimed to describe the quality of life of tuberculosis patients at baseline and its changes with treatment and to investigate the relationship between the quality of life and socio-demographic and clinical variables. Methods A prospective cohort study of newly diagnosed active tuberculosis patients was conducted between January 2021 and June 2022. The short-form 12 version 2 (SF12v2) questionnaire was administered at baseline, and follow-up was done at the end of the intensive phase and end of treatment to assess participants' health-related quality of life at each stage of treatment. Higher physical and mental component summary scores indicate better quality of life. To identify independent relationships with quality of life, a logistic regression model was performed. Results At the start of treatment, 78.8% of participants had a physical impairment, while 25.7% were at risk of depression. Even though the quality of life improved with treatment, 59.5% of participants still had a physical impairment, and 15.5% were depressed at the end of treatment. Alcohol use (p = 0.03) and HIV infection (p = 0.021) reduced mental health at baseline. Predictors of physical impairment at the end of therapy include age > 45 years (p = 0.044), female gender (p = 0.01), unemployment (p = 0.009), pulmonary TB (p = 0.001) and starting HIV treatment before TB (p = 0.002). There was a clinically significant improvement in the physical component summary score (3.3) but not in mental health (1.7). Conclusion Tuberculosis significantly affects patients’ quality of life even after completing treatment. Identifying patients who are at greater risk and instituting preventive measures could improve their quality of life for holistic care.