Quality of life in Malaysian children with inflammatory bowel disease: An understudied population.

Abstract

Quality of life (QoL) in children with inflammatory bowel disease (IBD) is often impaired by underlying disease. We evaluated factors affecting health-related QoL (HRQoL) in Malaysian children with IBD. A cross-sectional study using IMPACT-III questionnaires evaluating HRQoL in children aged 8-17 years with duration of IBD of ≥6months was conducted. IMPACT-III, a validated instrument designed to measure HRQoL in children with IBD, was used. Higher IMPACT-III (maximum=100) score indicates better HRQoL. Impact of socio-demographic and clinical factors of IBD on the HRQoL was evaluated. Paediatric Crohn's disease (CD) and ulcerative colitis (UC) activity indices were used to classify disease severity. A total of 75 children (UC=44, CD=41; mean (SD) age at diagnosis 8.2 (3.5) years) were interviewed at mean age of 12.8 (2.7) years. Mean IMPACT-III score was significantly lower in children with more severe disease (mild: 71.8 (13.6) vs. moderate: 65.5 (10.9) vs. severe: 46.3 (14.5); P< 0.001), history of hospitalisation (yes: 64.0 (14.0) vs. none: 74.1 (12.2), P= 0.034) and a higher number of admissions (r= -0.352, P= 0.041) in preceding 6months. Diagnosis at a younger age (r= -0.31, P= 0.007) and a longer duration of disease (r=0.286, P= 0.013) was associated with higher score. A higher weight-for-age (r= 0.261, P= 0.023) or body mass index-for-age z-score (r= 0.235, P= 0.042) was correlated with a better body image domain score, respectively. In Malaysian children with IBD, HRQoL was adversely affected by a more severe disease. Better control of disease activity and maintaining long-term remission are important to improve the HRQoL in childhood IBD.