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Beyond ‘cure' and ‘treatment success': quality of life of patients with multidrug-resistant tuberculosis

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SETTING: Two drug-resistant tuberculosis (DR-TB) sites (MSF Clinic, Jupiter Hospital) in Mumbai, India.

OBJECTIVE: To assess health-related quality of life (HRQoL) and associated factors among DR-TB patients and explore their perspectives about HRQoL.

DESIGN: We used a mixed-methods design: a quantitative cross-sectional questionnaire (the World Health Organization's Quality of Life Brief Questionnaire [WHOQoL-BREF]); and qualitative in-depth interviews for purposively selected patients. Assessments were conducted between April and November 2016.

RESULTS: Ninety-five patients completed WHOQoL-BREF; 12 were interviewed. The psychological and physical health domains were the most affected (mean scores 56.2 ± standard deviation [SD] 18.3, and 56.5 ± SD 15.1, respectively; maximum 100). The social relations and environmental domains mean scores were respectively 68.6 (SD ±21.1) and 60.3 (SD ±15.9). Loss of jobs due to TB adversely affected the social relations and environmental domains. Qualitative analysis showed that support was the most important theme affecting quality of life. Other themes were physical factors (e.g., treatment adverse events), psychological factors (e.g., depression), social functioning (e.g., fear of stigmatisation) and environmental factors (e.g., health systems).

CONCLUSION: HRQoL was lower among study participants, but not as low as previously reported among TB patients. Support was the main factor that positively affected HRQoL, although both disease and treatment were physically and socially challenging.
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Keywords: MDR-TB; SORT IT; XDR-TB; operational research; quality of life

Document Type: Research Article

Affiliations: 1: Médecins Sans Frontières (MSF), Mumbai, India 2: University of Exeter, Exeter, UK 3: Jupiter Hospital, Thane 4: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India, The Union, Paris, France 5: Pondicherry Institute of Medical Sciences, Puducherry 6: Tata Institute of Social Sciences, Mumbai, India 7: Médecins Sans Frontières (MSF), Mumbai, India, MSF, Operational Research Unit, Luxembourg City, Luxembourg

Publication date: January 1, 2019

More about this publication?
  • 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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