Obstructive lung disease and quality of life after cure of multi-drug-resistant tuberculosis in Uganda: a cross-sectional study.

Journal: Tropical medicine and health

Volume: 48

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Medicine, Mbarara University of Science and Technology, P.O Box , Mbarara, Uganda. Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN USA. Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda. Section of Pulmonary, Critical Care and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, MN USA.

Abstract summary 

Pulmonary multi-drug-resistant tuberculosis (MDR TB) alters lung architecture and involves lengthy treatment duration, high pill burden, drug adverse effects, travel restrictions, and stigma. Literature about pulmonary function and health-related quality of life (QoL) of patients treated for MDR TB is limited. This study sought to determine the prevalence of chronic obstructive pulmonary disease (COPD) and QoL of patients who were treated for pulmonary MDR TB.Participants who completed 18 months of pulmonary MDR TB treatment and considered cured were eligible to be evaluated in a cross-sectional study. We performed post-bronchodilator spirometry to measure forced expiratory volume in 1 s (FEV) and forced vital capacity (FVC). COPD was defined as FEV/FVC < 0.7; health-related QoL was assessed using the Medical Outcomes Survey for HIV (MOS-HIV) and St. George's Respiratory Questionnaire (SGRQ). Linear and logistic regression models were used to assess associations with COPD, health-related QoL, and other characteristics of the cohort.A total of 95 participants were enrolled. Median age of the cohort was 39 years (interquartile range (IQR), 29-45), and 55 (58%) were HIV-positive. COPD prevalence was 23% (22/95). Median SGRQ score was normal at 7.8 (IQR, 3.1-14.8). Median mental and physical health summary scores were significantly impaired, at 58.6 (IQR, 52.0-61.5) and 52.9 (IQR, 47.8-57.9), respectively, on a scale of 0 to 100 where 100 represents excellent physical or mental health. In this sample, 19% (18/95) of participants were in the lowest relative socioeconomic position (SEP) while 34% (32/95) were in the highest relative SEP. Belonging in the lowest SEP group was the strongest predictor of COPD.Individuals who have completed MDR TB treatment have a high prevalence of COPD and low mental and physical health summary scores. Our study highlights the need for pulmonary rehabilitation programs in patients with a low socioeconomic position (SEP) after MDR TB treatment.

Authors & Co-authors:  Nuwagira Edwin E Stadelman Anna A Baluku Joseph Baruch JB Rhein Joshua J Byakika-Kibwika Pauline P Mayanja Harriet H Kunisaki Ken M KM

Study Outcome 

Source Link: Visit source

Statistics
Citations :  World Health Organisation. Global Tuberculosis Report 2019 [Internet]. [cited 2020 Apr 8] p. 59, Box2. Available from: https://apps.who.int/iris/bitstream/handle/10665/329368/9789241565714-eng.pdf?ua=1.
Authors :  7
Identifiers
Doi : 34
SSN : 1348-8945
Study Population
Male,Female
Mesh Terms
Other Terms
COPD;HIV;Multi-drug-resistant tuberculosis;Quality of life;Uganda
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
Japan