Abstract
BackgroundMigrants are known to be predominantly poor population which are predisposing to social and health problems, particularly infectious diseases including tuberculosis (TB). TB itself and effect of treatment may further result in substantial morbidity and lowering the quality of life. This study aimed to assess the changes in health-related quality of life (HRQOL) within six months of anti-TB treatment initiation, and the associated factors in Myanmar migrants under anti-TB treatment within this border area.MethodsThis was a prospective cohort study of adult Myanmar migrants with new TB who were within two months of treatment initiation in two TB clinics in Mae Sot, a Thai-Myanmar border area between September 2019 and July 2020. Eight individual domain scores of the HRQOL and Physical and Mental Component Summary (PCS and MCS) scores measured by SF-36 were calculated at month-2 (T1) as baseline, and at the month-4 (T2) and month-6 follow-up visits (T3). Generalized estimation equation models were used to assess the longitudinal changes in PCS and MCS scores of HRQOL.ResultsOf the 155 patients recruited, 93 (60.0%) and 65 (69.9%) completed the month-4 and month-6 follow-ups, respectively. Both the PCS (+ 6.1) and MCS (+ 6.3) scores significantly improved between T1 and T3, with the lowest scores being general health, with the least improvement in social function (+ 1.5) compared with the other domains. Migrants with ethnic origin of Burmese or other were associated with higher PCS and MCS. Those living with family and having higher numbers of initial TB symptoms were associated with lower PCS and MCS scores. Those diagnosed during routine medical checkup were positively associated with PCS scores, whereas patients diagnosed during active case findings were negatively associated with MCS scores. Patients who received residential TB care had higher PCS scores than those with OPD-based TB care.ConclusionsContinuous improvement in quality of life was found among Myanmar migrants with TB during treatment but their quality of life is still low. Patients with low mental health, especially in the social domain, requires further attention. Active screening policy and supportive strategies during treatment are essential to TB migrants.
Highlights
Migrants are known to be predominantly poor population which are predisposing to social and health problems, infectious diseases including tuberculosis (TB)
Since 2009, the Shoklo Malaria Research Unit (SMRU) has provided a TB program for migrants living in the border area including TB treatment, residential care, food, psycho-social counselling and other necessities free of charge
Study sample All Myanmar migrants, aged 18 years or above, with new TB who were under two months of anti-TB treatment at the study clinics between 1st September 2019 and 31st July 2020, were included in this study
Summary
Migrants are known to be predominantly poor population which are predisposing to social and health problems, infectious diseases including tuberculosis (TB). This study aimed to assess the changes in health-related quality of life (HRQOL) within six months of anti-TB treatment initiation, and the associated factors in Myanmar migrants under anti-TB treatment within this border area. Active TB has a substantially detrimental impact on health-related quality of life (HRQOL) in both physical well-being and psychological distress or depression [2, 3]. Migrants are predisposed to contracting TB [10], which may be related to their social determinants of health that carries a risk of health and/or social wellbeing problems [11, 12]. The regions of origin were mostly from Africa, Europe, and America
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