DETERMINANTS OF HEALTH RELATED QUALITY OF LIFE IN SMEAR POSITIVE

AND SMEAR NEGATIVE ADULT TUBERCULOSIS PATIENTS IN

KAMPALA, UGANDA.

JOY KUSIIMA. B
2011/HD07/2267U

DISSERTATION

SUBMITTED

IN

PARTIAL

FULFILMENT

OF

THE

REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTER OF HEALTH

SERVICES RESEARCH OF MAKERERE UNIVERSITY, KAMPALA

ABSTRACT

Introduction/background: Smear negative Tuberculosis has been on the rise since the HIV
epidemic and is associated with poor clinical outcomes. There is limited information regarding
health related quality of life(HRQoL) among in patients with smear negative Tuberculosis
compared to those who have smear positive TB.
Objective: To compare HRQoL scores in smear positive and smear negative TB patients and
determine predictors of quality of life in TB patients using the WHO_BREF tool.
Methodology: This was a cross sectional study among 216 TB patients. Client exit interviews
were conducted. We used paired t-tests to analyze differences in mean scores, stratifying by
disease category and HIV status. Multiple linear regression models were used to establish factors
associated with HRQoL.
Results: Of the 208 participants, 56.2% were males, 51.4% were TB smear negative. Smear
negative TB patients had mean (SD) scores that were significantly lower in environment health
compared to smear positive patients; 52.04(14.86) versus 56.49 (13.57); p= 0.025. TB-HIV co
infected patients

recorded lower mean (SD) scores in social relationships and environment

health compared to those who only had TB; [61.26(21.8) versus 67.4 (17.69); p = 0.028)] and
50.7(13.7) versus;(57.8(13.7) p=0.0003 respectively. Having moderate to severe Depression was
associated with all health domains; physical (-17.43 (95% (CI;-23.08, -11.50)), social
relationships (-14.76 (95%CI;-25.64, -9.73)), environment (-10.96 (95%CI-16.63,-3.92)) and
Psychological (-16.86 (95% CI; -22.83, -10.90). Other predictors of HRQoL in different health
domains were; stigma (-5.33 (95% CI:-10.29, -0.37)), continuation phase of treatment (6.32

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(95%CI; 1.72, 10.92)), satisfaction with the social support; (4.39(95% CI; 0.85, 7.94)),
secondary education and above (6.38(95%CI; 1.86, 9.54)), and gender (4.37(95% CI; 1.68, 8.51).
Conclusion: Smear negative TB patients have lower scores of health quality of life in
environment health compared to smear positive patients. Health related quality of life in TB
patients is associated with depression, continuation phase of treatment, being female, having
received secondary education and above and, stigma.

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