Health-Related quality of life in multidrug resistant tuberculosis patients in Kaduna State, North-Western Nigeria: Comparisons among community and facility model of management

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 shortform (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 rogrammatic interventions to address the risk factors for poorer quality of life for the community model.