A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey

Abstract Background In many settings, Tuberculosis (TB) represents a catastrophic life event that substantially impairs a person’s Health-Related Quality of Life (HRQoL). We aimed to measure HRQoL among people with TB in Viet Nam at initiation and throughout treatment. Methods This study took place...

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Main Authors: Luan Nguyen Quang Vo, Rachel Forse, Andrew James Codlin, Huy Ba Huynh, Anja Maria Christine Wiemers, Jacob Creswell, Tushar Garg, Thi Minh Ha Dang, Lan Huu Nguyen, Hoa Binh Nguyen, Luong Van Dinh, Nhung Viet Nguyen, Tom Wingfield, Kristi Sidney Annerstedt, Jad Shedrawy, Knut Lönnroth
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Health and Quality of Life Outcomes
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Online Access:https://doi.org/10.1186/s12955-025-02369-9
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author Luan Nguyen Quang Vo
Rachel Forse
Andrew James Codlin
Huy Ba Huynh
Anja Maria Christine Wiemers
Jacob Creswell
Tushar Garg
Thi Minh Ha Dang
Lan Huu Nguyen
Hoa Binh Nguyen
Luong Van Dinh
Nhung Viet Nguyen
Tom Wingfield
Kristi Sidney Annerstedt
Jad Shedrawy
Knut Lönnroth
author_facet Luan Nguyen Quang Vo
Rachel Forse
Andrew James Codlin
Huy Ba Huynh
Anja Maria Christine Wiemers
Jacob Creswell
Tushar Garg
Thi Minh Ha Dang
Lan Huu Nguyen
Hoa Binh Nguyen
Luong Van Dinh
Nhung Viet Nguyen
Tom Wingfield
Kristi Sidney Annerstedt
Jad Shedrawy
Knut Lönnroth
author_sort Luan Nguyen Quang Vo
collection DOAJ
description Abstract Background In many settings, Tuberculosis (TB) represents a catastrophic life event that substantially impairs a person’s Health-Related Quality of Life (HRQoL). We aimed to measure HRQoL among people with TB in Viet Nam at initiation and throughout treatment. Methods This study took place in four provinces from Oct-2020 to Sep-2022. Persons initiated on TB treatment were consecutively recruited across three pathways to access care: passive case finding (NTP); active case finding (ACF); and private sector engagement (PPM). We conducted the EuroQol–5-Dimension–5-Level (EQ-5D-5L) survey during the intensive, continuation, and post-treatment phase. We described participant characteristics, assessed the survey’s psychometric properties, and calculated utility indexes using a Vietnamese value set. We reported these alongside visual analog scale (EQ-VAS) scores and EQ-5D-5L dimensions by treatment stage, care pathway and other participant characteristics. Mixed-effect Tobit models were fitted to identify relevant associations with HRQoL, which we compared to general population benchmarks. Results We recruited 585 participants (23.6% female) with a median age of 51 years. EQ-5D-5L dimensions at baseline showed that 53.8% experienced pain/discomfort and 35.0% felt anxiety/depression, while 33.8%, 30.4%, and 9.6% reported problems with carrying out usual activities, mobility, and self-care, respectively. The mean utility index was 0.83 (95% confidence interval: [0.82, 0.85]) and mean EQ-VAS was 67.1 (95%CI: [65.6, 68.6]). Post-treatment, HRQoL improved significantly on all dimensions and composite measures. While utility indexes were at parity with general population benchmarks (0.90; 95%CI: [0.89, 0.92] vs. 0.91), self-reported EQ-VAS scores remained significantly lower (79.4; 95%CI: [78.1, 80.6] vs. 87.4). HRQoL was higher at baseline in the ACF versus the NTP cohorts on utility index (0.87 vs. 0.82; p = 0.003) and EQ-VAS score (70.4 vs. 65.5; p = 0.015). The EQ-5D-5L tool demonstrated moderate to high validity on Cronbach’s alpha (0.75 ≤ α ≤ 0.84) and Spearman’s rho (0.4679 ≤ ρ 0 ≤ 0.5651) across treatment stages and various known groups. Conclusion TB significantly impairs HRQoL among affected Vietnamese people. While treatment partially remedies these impairments, they may persist post-TB. Hence, physical, psychological and social rehabilitation during and after therapy should receive more attention. We found evidence that ACF may mitigate TB-related declines in HRQoL, but tailored studies are needed to substantiate these findings.
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spelling doaj-art-d622eb7c3c164c4585c03f35cdeafd6f2025-08-20T03:06:06ZengBMCHealth and Quality of Life Outcomes1477-75252025-04-0123112110.1186/s12955-025-02369-9A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L surveyLuan Nguyen Quang Vo0Rachel Forse1Andrew James Codlin2Huy Ba Huynh3Anja Maria Christine Wiemers4Jacob Creswell5Tushar Garg6Thi Minh Ha Dang7Lan Huu Nguyen8Hoa Binh Nguyen9Luong Van Dinh10Nhung Viet Nguyen11Tom Wingfield12Kristi Sidney Annerstedt13Jad Shedrawy14Knut Lönnroth15Friends for International TB ReliefFriends for International TB ReliefFriends for International TB ReliefFriends for International TB ReliefFriends for International TB ReliefStop TB PartnershipStop TB PartnershipPham Ngoc Thach HospitalPham Ngoc Thach HospitalNational Lung HospitalNational Lung HospitalVNU University of Medicine and PharmacyCentre for Tuberculosis Research, Departments of Clinical Sciences and International Public Health, Liverpool School of Tropical MedicineDepartment of Global Public Health, Karolinska InstitutetDepartment of Global Public Health, Karolinska InstitutetDepartment of Global Public Health, Karolinska InstitutetAbstract Background In many settings, Tuberculosis (TB) represents a catastrophic life event that substantially impairs a person’s Health-Related Quality of Life (HRQoL). We aimed to measure HRQoL among people with TB in Viet Nam at initiation and throughout treatment. Methods This study took place in four provinces from Oct-2020 to Sep-2022. Persons initiated on TB treatment were consecutively recruited across three pathways to access care: passive case finding (NTP); active case finding (ACF); and private sector engagement (PPM). We conducted the EuroQol–5-Dimension–5-Level (EQ-5D-5L) survey during the intensive, continuation, and post-treatment phase. We described participant characteristics, assessed the survey’s psychometric properties, and calculated utility indexes using a Vietnamese value set. We reported these alongside visual analog scale (EQ-VAS) scores and EQ-5D-5L dimensions by treatment stage, care pathway and other participant characteristics. Mixed-effect Tobit models were fitted to identify relevant associations with HRQoL, which we compared to general population benchmarks. Results We recruited 585 participants (23.6% female) with a median age of 51 years. EQ-5D-5L dimensions at baseline showed that 53.8% experienced pain/discomfort and 35.0% felt anxiety/depression, while 33.8%, 30.4%, and 9.6% reported problems with carrying out usual activities, mobility, and self-care, respectively. The mean utility index was 0.83 (95% confidence interval: [0.82, 0.85]) and mean EQ-VAS was 67.1 (95%CI: [65.6, 68.6]). Post-treatment, HRQoL improved significantly on all dimensions and composite measures. While utility indexes were at parity with general population benchmarks (0.90; 95%CI: [0.89, 0.92] vs. 0.91), self-reported EQ-VAS scores remained significantly lower (79.4; 95%CI: [78.1, 80.6] vs. 87.4). HRQoL was higher at baseline in the ACF versus the NTP cohorts on utility index (0.87 vs. 0.82; p = 0.003) and EQ-VAS score (70.4 vs. 65.5; p = 0.015). The EQ-5D-5L tool demonstrated moderate to high validity on Cronbach’s alpha (0.75 ≤ α ≤ 0.84) and Spearman’s rho (0.4679 ≤ ρ 0 ≤ 0.5651) across treatment stages and various known groups. Conclusion TB significantly impairs HRQoL among affected Vietnamese people. While treatment partially remedies these impairments, they may persist post-TB. Hence, physical, psychological and social rehabilitation during and after therapy should receive more attention. We found evidence that ACF may mitigate TB-related declines in HRQoL, but tailored studies are needed to substantiate these findings.https://doi.org/10.1186/s12955-025-02369-9TuberculosisPatient-reported outcome measuresHealth-related quality of lifeEQ-5D-5LViet NamLongitudinal
spellingShingle Luan Nguyen Quang Vo
Rachel Forse
Andrew James Codlin
Huy Ba Huynh
Anja Maria Christine Wiemers
Jacob Creswell
Tushar Garg
Thi Minh Ha Dang
Lan Huu Nguyen
Hoa Binh Nguyen
Luong Van Dinh
Nhung Viet Nguyen
Tom Wingfield
Kristi Sidney Annerstedt
Jad Shedrawy
Knut Lönnroth
A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey
Health and Quality of Life Outcomes
Tuberculosis
Patient-reported outcome measures
Health-related quality of life
EQ-5D-5L
Viet Nam
Longitudinal
title A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey
title_full A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey
title_fullStr A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey
title_full_unstemmed A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey
title_short A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey
title_sort life that s worth living measuring health related quality of life among people treated for tuberculosis in viet nam a longitudinal eq 5d 5l survey
topic Tuberculosis
Patient-reported outcome measures
Health-related quality of life
EQ-5D-5L
Viet Nam
Longitudinal
url https://doi.org/10.1186/s12955-025-02369-9
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