Health-Related Quality of Life in Multidrug Resistant Tuberculosis Patients in Kaduna State, North-Western Nigeria: Comparisons among community and facility model of management

Authors

  • AM Oyefabi DEPARTMENT OF COMMUNITY MEDICINE, FACULTY OF CLINICAL SCIENCE, COLLEGE OF MEDICINE, KADUNA STATE UNIVERSITY, NIGERIA
  • S Ameh Department of Community Medicine, University of Calabar, Cross River State, Nigeria
  • CI Tobin-West School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria
  • SI Kure Department of Community Medicine, Kaduna State University, Nigeria
  • J Akabe Department of Community Medicine, Kaduna State University, Nigeria

Keywords:

MDR –TB, Community, Facility, models, comparative, QOL

Abstract

Background: The community management of the drug resistant tuberculosis (MDR-TB) was introduced after several years of absolute facility model of care to reduce the logistic and social problems associated with hospital admissions of the MDR-TB patients. This study compares the health-related Quality of life (HRQOL) of patients receiving facility and community-based model of care.

Methods: This was a mixed methods design combining a quantitative cross-sectional survey, a focus group discussion and in-depth interviews with DR TB stakeholders. The study was conducted among 62 MDR TB patients who were managed for MDR TB in Kaduna State from January – June 2022.  The QOL data were collected with the modified 36-item short-form (SF-36).  Statistical significance was set at p<0.05

Result: The total quality of life (TQL) was 69.14+16.29. The facility mean QOL for role limitation, RL (88.89+8.54), Role emotional, RE (88.89+8.54) and social functioning SF (81.25+7.62) were significantly higher compared to the community model with RL (56.48+7.13) RE (58.03+7.88) and SF(67.69+3.79) The physical component scores (95%CI =62.99-74.47) and the Mental Component scores (95% CI=63.64-75.42) were significantly higher in the facility compared to the community-based care. The FGDs and KII revealed that challenges with training for health care providers, poor supportive supervision and support for home visits were factors affecting community model of MDR-TB.

Conclusion: The patients managed at the facility had a better QOL than those at the community. There is a need for programmatic interventions to address the risk factors for poorer quality of life for the community model. 

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Published

2023-01-07 — Updated on 2023-03-16

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OYEFABI, A. M., Ameh, S., Tobin-West, C., Kure, S., & Akabe, J. (2023). Health-Related Quality of Life in Multidrug Resistant Tuberculosis Patients in Kaduna State, North-Western Nigeria: Comparisons among community and facility model of management. The Nigerian Health Journal, 22(4), 440–447. Retrieved from https://tnhjph.com/index.php/tnhj/article/view/633 (Original work published January 7, 2023)

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