Quality of life, tuberculosis and treatment outcome; a case-control and nested cohort study.

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.

Interventions aiming to eliminate catastrophic costs due to tuberculosis: a protocol for a systematic review and meta-analysis.

Background : People with tuberculosis disease and their household members may suffer direct out-of-pocket expenses and indirect costs of lost income. These tuberculosis-related costs can worsen poverty, make tuberculosis treatment completion unaffordable, impair quality of life and increase the risk of death. Costs due to tuberculosis are usually defined as catastrophic if they exceed 20% of the pre-disease annual household income. The World Health Organisation strategy to "End TB" and the United Nations Sustainable Development Goals include the target that no households should face catastrophic costs due to tuberculosis. However, there is limited evidence and policy concerning how this global priority of eliminating catastrophic costs due to tuberculosis should be achieved. This systematic review and meta-analysis aims to address this knowledge gap. Methods : Publications assessing interventions that aimed to eliminate catastrophic costs will be identified by searching three electronic databases (PubMed, Scopus and Web of Science) together with reference lists from pertinent publications. We will screen eligible studies, extract data, and assess the risk of bias with the quality assessment tool from the National Heart, Lung, and Blood Institute. Discrepancies will be resolved by discussion between the reviewers. If we find sufficient comparable studies quantifying strategies to eliminate catastrophic costs then a meta-analysis will be performed. This systematic review and meta-analysis is registered with the PROSPERO database (CRD42022292410). Conclusion : This systematic review and meta-analysis aims to rigorously assess the evidence for strategies to eliminate catastrophic costs due to tuberculosis.

Relación del soporte familiar y social en el cumplimiento del tratamiento de pacientes con tuberculosis pulmonar en centros de salud / Relationship of family and social support in implementing the treatment of patients with pulmonary tuberculosis in health

Objetivos: Determinar la relación del soporte familiar y social en el cumplimento del tratamiento de pacientes con Tuberculosis Pulmonar. Material y métodos: tipo de estudio descriptivo de corte transversal, correlacional. La población estuvo conformada por 52 pacientes que estuvieron registrados en la Estrategia Sanitaria Nacional de Prevención y Control de la Tuberculosis en los Centros de Salud: Flor de Amancaes y San Juan de Amancaes. Se utilizó como técnica la encuesta, a través de dos cuestionarios validados por juicio de expertos, instrumentos que midieron el soporte familiar y social en el cumplimiento del tratamiento. Resultados: Un 81,8% de los pacientes que recibieron nivel alto de soporte familiar y social presentaron cumplimiento del tratamiento, mientras que un 36.4%, que recibieron bajo nivel de soporte familiar y social presentaron ¿cumplimiento? del tratamiento. La diferencia encontrada resultó estadísticamente significativa (p=0,034). Mientras que un 59.6% de los pacientes cumplen con el tratamiento, y un 40,4% no lo cumplen. Conclusiones: el soporte familiar y social es un eje importante en la recuperación del paciente, ya que el paciente se siente más confiado y motivado a culminar con su tratamiento para recuperarse pronto y reinsertarse a su vida cotidiana.

Objectives: To determine the relationship of family and social support in the treatment compliance of patients with pulmonary tuberculosis. Material and methods: The study was a descriptive type of cross-sectional correlation of the 52 patients who were registered in the National Health Strategy for Prevention and Control of Tuberculosis in Health Centers: ¨Flor de Amancaes¨ and ¨San Juan de Amancaes.¨ Data collection: A survey was used as a technique and the survey was conducted through two questionnaires and validated by an expert judgment. The instruments that measure family and social support and adherence to treatment of patients with pulmonary tuberculosis have acceptable level´s of reliability. Results: 81.8% of the patients who received a high level of family and social support showed compliance, while 36.4% received a low level of family and social support showed compliance. The difference found was statistically significant (p =0.034). 59.6% of the patients complied with treatment, while 40.4% did not. Conclusions: family and social support is an important factor in the patient recovery axis, since the patient will feel more confident and motivated to finish the treatment and recover soon and reintegrate into their daily lives.