Abstract
BackgroundActive tuberculosis (TB) disease can impose substantial morbidity, while treatment for latent TB infection (LTBI) has frequent side effects. We compared health-related quality of life (HRQOL) between persons diagnosed and treated for TB disease, persons treated for LTBI, and persons screened but not treated for TB disease or LTBI, over one year following diagnosis/initial assessment.MethodsParticipants were recruited at two hospitals in Montreal (2008–2011), and completed the Short Form-36 version 2 (SF-36) at baseline, and at 1, 2, 4, 6, 9, and 12 months thereafter. Eight domain scores and physical and mental component summary (PCS and MCS, respectively) scores were calculated from responses. Linear mixed models were used to compare mean scores at each evaluation and changes in scores over consecutive evaluations, among participants treated for TB disease and those treated for LTBI, each compared to the control group.ResultsOf the 263 participants, 48 were treated for TB disease, 105 for LTBI, and 110 were control participants. Fifty-four percent were women, mean age was 35 years, and 90% were foreign-born. Participants treated for TB disease reported significantly worse mean scores at baseline compared to control participants (mean PCS scores: 50.0 vs. 50.7; mean MCS scores: 46.4 vs. 51.1), with improvement in mean MCS scores throughout the study period. Scores reported by participants treated for LTBI and control participants were comparable throughout the study.ConclusionTB disease is associated with decrements in HRQOL as measured by the SF-36. This is most pronounced during the weeks after diagnosis and treatment initiation, but is no longer evident after two months.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-015-0250-4) contains supplementary material, which is available to authorized users.
Highlights
Active tuberculosis (TB) disease can impose substantial morbidity, while treatment for latent TB infection (LTBI) has frequent side effects
Our study reports longitudinal measures of health-related quality of life (HRQOL) over the year following diagnosis, as measured with the Short Form-36 version 2 (SF-36) questionnaire, reported by patients recruited from two hospitals in Montreal, Canada who were treated for TB disease or LTBI [11,12]
Among participants treated for TB disease, 21 (44%) missed at least one follow-up visit, and 4 (8%) participants provided data to permit calculation of both Physical Component Summary of the SF-36 (PCS) and Mental Component Summary of the SF-36 (MCS) scores at every follow-up visit
Summary
Active tuberculosis (TB) disease can impose substantial morbidity, while treatment for latent TB infection (LTBI) has frequent side effects. In high-income countries, like Canada, many patients diagnosed with latent TB infection (LTBI) receive treatment. This treatment usually involves isoniazid (INH) taken daily for 9 months; treatment completion is often. An overwhelming majority of individuals screened and treated for LTBI and TB disease in high-income countries are recent immigrants [3,7,8]. A key challenge of research describing HRQOL of patients treated for LTBI and TB disease is to tease apart the impact of diagnosis and treatment from that of typical stressors facing the immigrant population such as language barriers, social isolation, unemployment, unstable housing, access to health care, etc. A key challenge of research describing HRQOL of patients treated for LTBI and TB disease is to tease apart the impact of diagnosis and treatment from that of typical stressors facing the immigrant population such as language barriers, social isolation, unemployment, unstable housing, access to health care, etc. [9,10]
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