Effects of comorbidities on quality of life in Filipino people with tuberculosis
METHODS: Adult participants were enrolled in public facilities in Metro Manila (three sites) and Negros Occidental (two sites). Multivariate linear regression was used to model the four correlated domain scores from a WHOQOL-BREF questionnaire (physical, psychological, social, environmental). A forward-stepwise approach was used to select a final multivariable model with inclusion based on global tests of significance at P < 0.1.
RESULTS: In 446 people on drug-susceptible TB treatment, DM and moderate/severe anaemia were not associated with HrQoL. After adjustment for age, sex, education, food insecurity, treatment adherence, inflammation, Category I or II TB treatment, treatment phase, current side effects and inhibited ability to work, moderate/severe undernutrition (body mass index < 17 kg/m2) was associated with lower HrQoL (P = 0.003) with reduced psychological (coefficient: −1.02, 95% CI −1.54 to −0.51), physical (−0.62, 95% CI −1.14 to −0.09) and environmental domain scores (−0.45, 95% CI −0.88 to −0.01). In 225 patients with known HIV status in Metro Manila, HIV was associated with modestly reduced HrQoL (P = 0.014).
CONCLUSION: Nutritional status and food insecurity represent modifiable risk factors for poor HrQoL that may be alleviated through interventions.
Keywords: comorbidities; diabetes; malnutrition; quality of life; the Philippines; tuberculosis
Document Type: Research Article
Affiliations: 1: Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine (LSHTM), London, UK, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan 2: School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan 3: School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan, Royal Free Hospital, London, UK 4: Nutrition Center Philippines, Manila 5: San Lazaro Hospital, Manila 6: Valladolid Health Center, Valladolid, Negros Occidental 7: Bago City Health Center, Bago City, Negros Occidental, the Philippines 8: Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan 9: National TB Control Programme, Department of Health, Manila, the Philippines 10: School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, Faculty of Population Health, LSHTM, London, UK
Publication date: 01 July 2020
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