COMPARATIVE STUDY OF PERCEIVED HEALTH-RELATED QUALITY OF LIFE AND WELLBEING OF HIV PATIENTS WITH AND WITHOUT TB CO-INFECTION AT UNIVERSITY OF PORT-HARCOURT TEACHING HOSPITAL, PORT-HARCOURT, N

ABSTRACT

Background: Health-Related Quality of Life is a multidimensional construct referring to patient’s perception of the impact of disease and treatment on their physical, psychological, social function and wellbeing. HIV and Tuberculosis are two diseases of public health importance and there is paucity of data on the quality of life of patients who suffer from these diseases in Nigeria. This study was carried out to measure, compare and identify factors affecting health-related quality of life of patients with HIV and HIV/TB co-infection in adult patients attending the Anti-Retroviral Clinic of the University of Port-Harcourt Teaching Hospital.

Methodology: This was a comparative cross-sectional study of 144 patients with HIV only and 144 HIV/TB co-infected patients. Every consecutive patient who met the inclusion criteria was recruited over three months. Interviewer administered questionnaires were used to collect data on socio-demographic, socio-economic, medical and lifestyle information from consenting patients. The questionnaires adopted the 26-item WHO Quality of Life instrument – short version (WHOQOL-BREF) and Quality of Wellbeing Self Administered scale (QWB-SA) to measure the HRQOL and wellbeing among study participants.

Results: The mean ages were 35.69 ± 10.28 and 36.03 ± 10.92 among HIV only and HIV/TB co-infected groups respectively (p=0.532). Majority of respondents in both groups were females. Over 45% of respondents in both groups had secondary education with 62.5% of HIV patients and HIV/TB co-infected in the lower social classes IV and V. The score for HRQOL ranged from 61.9 to 78.5 in the HIV only group and 61.6 to 75.8 in the HIV/TB co-infected group. The HIV/TB co-infected patients had lower QOL in the physical (p=0.016) and psychological (p=0.006) and global (p=0.029) domains of QOL. Respondents with higher level of education had a better HRQOL compared to those with lower educational level in the HIV only group (p=0.04).The proportion of respondents with good QOL increased as household income increased in the HIV group (p=0.0025).Other factors showed no statistically significant association (p>0.05).

Conclusion: HIV/TB co-infected patients had lower quality of life in overall health, and in the physical and psychological domains of QOL when compared to those with HIV only. The two groups did not differ significantly in the social and environmental domains. Educational level and household income were significant factors found to affect quality of life.

Recommendation: The TB control program should design strategies to improve the quality of life of HIV/TB co-infected patients. Physical and psychological health should be targeted for intervention to improve the quality of life of patients with HIV/TB co-infection.