PT  - JOURNAL ARTICLE
AU  - Datta, Sumona
AU  - Gilman, Robert H.
AU  - Montoya, Rosario
AU  - Quevedo Cruz, Luz
AU  - Valencia, Teresa
AU  - Huff, Doug
AU  - Saunders, Matthew J.
AU  - Evans, Carlton A.
TI  - Quality of life, tuberculosis and treatment outcome; a case–control and nested cohort study
AID  - 10.1183/13993003.00495-2019
DP  - 2020 Aug 01
TA  - European Respiratory Journal
PG  - 1900495
VI  - 56
IP  - 2
4099  - http://erj.ersjournals.com/content/56/2/1900495.short
4100  - http://erj.ersjournals.com/content/56/2/1900495.full
SO  - Eur Respir J2020 Aug 01; 56
AB  - Background Global tuberculosis policy increasingly emphasises broad tuberculosis impacts and highlights the lack of evidence concerning tuberculosis-related quality of life (QOL).Methods Participants were recruited in 32 Peruvian communities between July 13, 2016 and February 24, 2018 and followed-up until November 8, 2019. Inclusion criteria were age ≥15 years for “patients” (n=1545) starting treatment for tuberculosis disease in health centres; “contacts” (n=3180) who shared a patient's household for ≥6 h·week−1; and randomly selected “controls” (n=277). The EUROHIS-QOL questionnaire quantified satisfaction with QOL, health, energy, activities of daily living (ADL), self, relationships, money and living place.Findings Newly diagnosed tuberculosis was most strongly associated with lower QOL scores (p<0.001). Patients initially had lower QOL than controls for all EUROHIS-QOL questions (p≤0.01), especially concerning health, ADL and self. Lower initial QOL in patients predicted adverse treatment outcomes and scores <13 points had 4.2-fold (95% CI 2.3–7.6) increased risk of death versus those with higher QOL scores (both p<0.001). Patient QOL was re-assessed 6 months later, and for patients with successful treatment QOL became similar to participants who had never had tuberculosis, whereas patients who did not complete treatment continued to have low QOL (p<0.001). Multidrug-resistant tuberculosis was associated with lower QOL before and during treatment (both p<0.001). Contacts had lower QOL if they lived with a patient who had low QOL score (p<0.0001) or were a caregiver for the patient (p<0.001).Conclusions Tuberculosis was associated with impaired psychosocioeconomic QOL which recovered with successful treatment. Low QOL scores predicted adverse treatment outcome. This brief EUROHIS-QOL eight-item questionnaire quantified the holistic needs of tuberculosis-affected people, potentially guiding patient-centred care.The brief EUROHIS quality-of-life questionnaire can be applied to assist in providing holistic, personalised care to TB-affected families, and guide multisystem interventions required to improve their wellbeing and TB treatment outcome https://bit.ly/2VhDKFM