Health related quality of life of tuberculosis patients in South India: A longitudinal assessment study.

<h4>Background</h4>In India, there is no information on health related quality of life (HRQoL) of patients with drug sensitive tuberculosis (TB) using a longitudinal design that includes post- treatment period. This study is the first of its kind in India to assess HRQoL of TB patients f...

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Main Authors: Vasantha Mahalingam, Muniyandi Malaisamy, Bella Devaleenal Daniel, Adhin Bhaskar, Lavanya Jayabal, Lakshmi Murali, Bharadhidasan Palani, Kavi Mathiyazhagan, Sai Madhu Yadla, Padmanaban Srinivasan, Ponnuraja Chinnaiyan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0328484
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author Vasantha Mahalingam
Muniyandi Malaisamy
Bella Devaleenal Daniel
Adhin Bhaskar
Lavanya Jayabal
Lakshmi Murali
Bharadhidasan Palani
Kavi Mathiyazhagan
Sai Madhu Yadla
Padmanaban Srinivasan
Ponnuraja Chinnaiyan
author_facet Vasantha Mahalingam
Muniyandi Malaisamy
Bella Devaleenal Daniel
Adhin Bhaskar
Lavanya Jayabal
Lakshmi Murali
Bharadhidasan Palani
Kavi Mathiyazhagan
Sai Madhu Yadla
Padmanaban Srinivasan
Ponnuraja Chinnaiyan
author_sort Vasantha Mahalingam
collection DOAJ
description <h4>Background</h4>In India, there is no information on health related quality of life (HRQoL) of patients with drug sensitive tuberculosis (TB) using a longitudinal design that includes post- treatment period. This study is the first of its kind in India to assess HRQoL of TB patients from a longitudinal prospective and to identify the factors associated with changes in HRQoL.<h4>Methods</h4>The study participants were 180 newly diagnosed drug-sensitive smear-positive pulmonary TB patients who were initiated on treatment under the National TB Elimination Programme (NTEP) in Chennai and Tiruvallur districts of Tamil Nadu, South India. The patients were interviewed at four different time points between 2020 and 2023 using validated questionnaires assessing general health (European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L), Short Form health survey (SF-20)), disease specific (St. George's Respiratory Questionnaire (SGRQ)) and mental health including depression and anxiety (Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7)). The Friedman test was used to identify changes in HRQoL scores over time and generalised estimating equation (GEE) were applied to identify factors associated with HRQoL.<h4>Results</h4>HRQoL scores of TB patients, as measured by different scales showed significant improvement from treatment initiation to treatment completion. The GEE analysis showed that the EQ-5D-5L scores over follow-up visits were significantly lower in females (-0.038, p < 0.005) and higher in those who did not skip their main meal in a day (0.077, p < 0.001). The PHQ-9 and GAD-7 scores were significantly higher among females (0.609, p < 0.05; 0.531, p < 0.05). Additionally, PHQ-9 scores were also higher among patients from rural district (0.392, p < 0.05). The SF-20 scores were significantly lower in patients aged >45 years (-1.675, p < 0.05), female (-3.809, p < 0.001) and unemployed (-2.277, p < 0.005). The SGRQ scores were higher in patients aged >45 years (3.043, p < 0.01), females (4.256, p < 0.05) and those from rural district (2.219, p < 0.05). The HRQoL scores were significantly higher in patients who did not skip their main meal and lower in females irrespective of the scales used.<h4>Conclusion</h4>The HRQoL of TB patients improved significantly over a period of treatment. Gender, age, skipping main meals, region and employment status were the key factors influencing HRQoL. Focusing on HRQoL assessment in the care of TB patients could help to minimize physical, mental and social challenges and enable them to lead a normal life.
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spelling doaj-art-aa02ed90c0144543be6819bf4fe060b92025-08-20T03:22:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032848410.1371/journal.pone.0328484Health related quality of life of tuberculosis patients in South India: A longitudinal assessment study.Vasantha MahalingamMuniyandi MalaisamyBella Devaleenal DanielAdhin BhaskarLavanya JayabalLakshmi MuraliBharadhidasan PalaniKavi MathiyazhaganSai Madhu YadlaPadmanaban SrinivasanPonnuraja Chinnaiyan<h4>Background</h4>In India, there is no information on health related quality of life (HRQoL) of patients with drug sensitive tuberculosis (TB) using a longitudinal design that includes post- treatment period. This study is the first of its kind in India to assess HRQoL of TB patients from a longitudinal prospective and to identify the factors associated with changes in HRQoL.<h4>Methods</h4>The study participants were 180 newly diagnosed drug-sensitive smear-positive pulmonary TB patients who were initiated on treatment under the National TB Elimination Programme (NTEP) in Chennai and Tiruvallur districts of Tamil Nadu, South India. The patients were interviewed at four different time points between 2020 and 2023 using validated questionnaires assessing general health (European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L), Short Form health survey (SF-20)), disease specific (St. George's Respiratory Questionnaire (SGRQ)) and mental health including depression and anxiety (Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7)). The Friedman test was used to identify changes in HRQoL scores over time and generalised estimating equation (GEE) were applied to identify factors associated with HRQoL.<h4>Results</h4>HRQoL scores of TB patients, as measured by different scales showed significant improvement from treatment initiation to treatment completion. The GEE analysis showed that the EQ-5D-5L scores over follow-up visits were significantly lower in females (-0.038, p < 0.005) and higher in those who did not skip their main meal in a day (0.077, p < 0.001). The PHQ-9 and GAD-7 scores were significantly higher among females (0.609, p < 0.05; 0.531, p < 0.05). Additionally, PHQ-9 scores were also higher among patients from rural district (0.392, p < 0.05). The SF-20 scores were significantly lower in patients aged >45 years (-1.675, p < 0.05), female (-3.809, p < 0.001) and unemployed (-2.277, p < 0.005). The SGRQ scores were higher in patients aged >45 years (3.043, p < 0.01), females (4.256, p < 0.05) and those from rural district (2.219, p < 0.05). The HRQoL scores were significantly higher in patients who did not skip their main meal and lower in females irrespective of the scales used.<h4>Conclusion</h4>The HRQoL of TB patients improved significantly over a period of treatment. Gender, age, skipping main meals, region and employment status were the key factors influencing HRQoL. Focusing on HRQoL assessment in the care of TB patients could help to minimize physical, mental and social challenges and enable them to lead a normal life.https://doi.org/10.1371/journal.pone.0328484
spellingShingle Vasantha Mahalingam
Muniyandi Malaisamy
Bella Devaleenal Daniel
Adhin Bhaskar
Lavanya Jayabal
Lakshmi Murali
Bharadhidasan Palani
Kavi Mathiyazhagan
Sai Madhu Yadla
Padmanaban Srinivasan
Ponnuraja Chinnaiyan
Health related quality of life of tuberculosis patients in South India: A longitudinal assessment study.
PLoS ONE
title Health related quality of life of tuberculosis patients in South India: A longitudinal assessment study.
title_full Health related quality of life of tuberculosis patients in South India: A longitudinal assessment study.
title_fullStr Health related quality of life of tuberculosis patients in South India: A longitudinal assessment study.
title_full_unstemmed Health related quality of life of tuberculosis patients in South India: A longitudinal assessment study.
title_short Health related quality of life of tuberculosis patients in South India: A longitudinal assessment study.
title_sort health related quality of life of tuberculosis patients in south india a longitudinal assessment study
url https://doi.org/10.1371/journal.pone.0328484
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