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Open Access Research article

Change in quality of life: a follow up study among patients with HIV infection with and without TB in Ethiopia

Amare Deribew1*, Kebede Deribe1, Ayalu A Reda2, Markos Tesfaye3, Yohannes Hailmichael4, Todd Maja5 and Robert Colebunders67

Author affiliations

1 Department of Epidemiology, Jimma University, Jimma, Ethiopia

2 College of Public Health, Haromaya University, Alemaya, Ethiopia

3 Department of psychiatry, Jimma University, Jimma, Ethiopia

4 Department of Health Service management, Jimma University, Jimma, Ethiopia

5 Department of Health Studies, UNISA, PO Box 392, Pretoria, South Africa

6 Department of clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp, 2000, Belgium

7 Department of Epidemiology and Social Medicine, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, Antwerpen, 2610, Belgium

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Citation and License

BMC Public Health 2013, 13:408  doi:10.1186/1471-2458-13-408

Published: 29 April 2013

Abstract

Background

There is a dearth of literature on the impact of TB/HIV co-infection on quality of life (QoL). We conducted a study to assess the change in QoL over a 6-months period and its predictors among HIV-infected patients with and without TB in Ethiopia.

Methods

465 HIV-infected patients without TB and 124 TB/HIV co-infected patients were enrolled in a prospective study in February, 2009. 455 (98%) HIV-infected and 97 (78%) TB/HIV co-infected patients were followed for 6 months. Data on QoL at baseline and 6th month were collected by trained nurses through face to face interviews using the short Amharic version of the World Health Organization Quality of Life Instrument for HIV clients (WHOQOL HIV-Brief). Common Mental Disorder (CMD) was assessed using a validated version of the Kessler-10 scale. Multivariate analysis was conducted using generalized estimating equations (GEE) using STATA to assess change in QoL and its predictors.

Results

There was a statistically significant improvement of the physical, psychological, social, environmental and spiritual QoL at the 6th months follow up compared to the baseline for both groups of patients (P < 0.0001). The change in QoL in all dimension were more marked for TB/HIV co-infected patients compared to HIV-infected patients without TB.

A severe form of CMD was strongly associated with poorer physical QoL among TB/HIV co-infected individuals (β = −2.84; P = 0.000) and HIV clients without TB (β = −2.34; P = 0.000).

Conclusion

This study reveals that ART and anti-TB treatment significantly improve the QoL particularly among TB/HIV co-infected patients. We recommend that the ministry of health in collaboration with partners shall integrate mental health services into the TB/HIV programs and train health care providers to timely identify and treat CMD to improve QoL.

Keywords:
TB/HIV co-infection; Quality of life; Antiretroviral treatment; Common mental disorders; Ethiopia