title: Change in quality of life: a follow up study among patients with HIV infection with and without TB in Ethiopia.
abstract: BACKGROUND
  There is a dearth of literature on the impact of TB/HIV co-infection on quality of life (QoL). We conducted a study to assess the change in QoL over a 6-months period and its predictors among HIV-infected patients with and without TB in Ethiopia.
  
  
  METHODS
  465 HIV-infected patients without TB and 124 TB/HIV co-infected patients were enrolled in a prospective study in February, 2009. 455 (98%) HIV-infected and 97 (78%) TB/HIV co-infected patients were followed for 6 months. Data on QoL at baseline and 6th month were collected by trained nurses through face to face interviews using the short Amharic version of the World Health Organization Quality of Life Instrument for HIV clients (WHOQOL HIV-Brief). Common Mental Disorder (CMD) was assessed using a validated version of the Kessler-10 scale. Multivariate analysis was conducted using generalized estimating equations (GEE) using STATA to assess change in QoL and its predictors.
  
  
  RESULTS
  There was a statistically significant improvement of the physical, psychological, social, environmental and spiritual QoL at the 6th months follow up compared to the baseline for both groups of patients (P < 0.0001). The change in QoL in all dimension were more marked for TB/HIV co-infected patients compared to HIV-infected patients without TB.A severe form of CMD was strongly associated with poorer physical QoL among TB/HIV co-infected individuals (β = -2.84; P = 0.000) and HIV clients without TB (β = -2.34; P = 0.000).
  
  
  CONCLUSIONS
  This study reveals that ART and anti-TB treatment significantly improve the QoL particularly among TB/HIV co-infected patients. We recommend that the ministry of health in collaboration with partners shall integrate mental health services into the TB/HIV programs and train health care providers to timely identify and treat CMD to improve QoL.
authors.affiliation: Department of Epidemiology, Jimma University, Jimma, Ethiopia. amare_deribew@yahoo.com
authors.forename: Amare
authors.initials: A
authors.lastname: Deribew
authors.forename: Kebede
authors.initials: K
authors.lastname: Deribe
authors.forename: Ayalu A
authors.initials: AA
authors.lastname: Reda
authors.forename: Markos
authors.initials: M
authors.lastname: Tesfaye
authors.forename: Yohannes
authors.initials: Y
authors.lastname: Hailmichael
authors.forename: Todd
authors.initials: T
authors.lastname: Maja
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D044966:Anti-Retroviral Agents; D000995:Antitubercular Agents