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Health status of UK patients with active tuberculosis

Authors: Kruijshaar, M. E.1; Lipman, M.2; Essink-Bot, M-L.3; Lozewicz, S.4; Creer, D.5; Dart, S.6; Maguire, H.7; Abubakar, I.8

Source: The International Journal of Tuberculosis and Lung Disease, Volume 14, Number 3, March 2010 , pp. 296-302(7)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

OBJECTIVE: To assess the impact of tuberculosis (TB) and its treatment on patients' health status.

METHODS: Questionnaires were administered prospectively to patients at three clinics in London at diagnosis and 2 months into therapy. We assessed generic health-related quality of life (Short Form 36 [SF-36] and EQ-5D) and psychological burden (State-Trait Anxiety Short-Form, Center for Epidemiologic Studies Depression Scale, worry items).

RESULTS: Of the 61 participants (response rate 94%), 89% were non-UK born, 67% had pulmonary TB and 38% were aged 30–45 years. At diagnosis, scores for all eight SF-36 dimensions were significantly worse than UK general population norm scores. At follow-up, scores had improved significantly (P < 0.01), except for physical functioning and general health perception, but remained below the UK norm, except for vitality and mental health. Respondents' mean anxiety and depression scores were high at diagnosis (48 and 22, respectively), and anxiety scores remained high at follow-up. Worries most frequently reported concerned patients' own health (92%) and that of their family (82%).

CONCLUSIONS: TB patients suffer from significantly diminished health-related quality of life at diagnosis. Although treatment significantly improved patients' health status within 2 months, scores for many domains remain below UK norm scores. This emphasises the importance of a holistic approach to care and should inform the evaluation of future interventions.

Keywords: health status; health-related quality of life; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Respiratory and Systemic Infections, Centre for Infections, Health Protection Agency, London, UK 2: Department of Respiratory Medicine, Royal Free Hospital, London, UK 3: Department of Social Medicine, University of Amsterdam, Amsterdam, The Netherlands 4: Department of Respiratory Medicine, North Middlesex University Hospital, London, UK 5: Barnet and Chase Farm Hospitals National Health Service Trust, London, UK 6: Royal Free Hospital, North Central London TB Service, London, UK 7: London Regional Epidemiology Unit, Health Protection Agency, London, UK; and St Georges Hospital Medical School, London, UK 8: Department of Respiratory and Systemic Infections, Centre for Infections, Health Protection Agency, London, UK; and School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK

Publication date: March 1, 2010

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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