Measuring the Quality Of Life (QOL) of People Living With HIV/AIDS (PLWHA) With Highly Active Antiretroviral Therapy (HAART) in Addis Ababa Zenebework Hospital
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Date
2006-06
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Addis Abeba Universty
Abstract
A cross-sectional comparative study among 768 (262 People Living With HIV/AIDS
(PLWHA) on Highly Active Antiretroviral Therapy (HAART) in Zenebework Hospital and
506 their respective neighbors from Kolfe and Nifasilk sub cities) in Addis Ababa was
employed between December and February 2006, to assess Health Related Quality of
Life (HRQoL), Amharic translated standard Medical Outcome Study-HIV (MOS-HIV)
interview questionnaire collected information on health related quality of life while; a pre
tested interview questionnaire collected the socio demographic characteristics of both
cases and non-equivalent controls. Clinical data for antiretroviral participants was
collected using a prepared data extraction form. Some of the items, 11 dimensions and 2
aggregate physical (PHS) and mental (MHS) summary scores of the MOS-HIV were
used to evaluate the level and determinants of health related quality of life. The overall
response rate was 96.6%. Reliabilty coeffocients were > 0.70, except the general health
and vitality scales. MOS-HIV scores for PLWHA on HAART were correlted with pain,
energy, cognitve function,vitality, health destress and social funtions. Compared to their
neighbors, PLWHA on HAART scored lower mean points for physical functioning, pain,
energy, social functioning, vitality, health distress, mental and cognitive functioning
dimensions(P<0.000)for all. Between 7..3 to 33.6% of PLWHA on HAART and 3.6 to
11.1% of their neighbors reported substantial impairments in selected items containing
Physical and mental functions. Highest proportion (33.6%) of the HAART group admitted
health limitation in working at a job or around tie house followed by inability to do
moderate activities (27.9%) quite a lot of the time. Those HAART participants with
duration of treatment above the median 36 weeks obtained higher mean points than
those below for general health (P<0.05), physical functioning (P<0.001) and vitality
(P<0.05). PLWHA on HAART in clinical stages 1 and 2 were more likely to score high
mean points than those in clinical stages 3 and 4. Significant associations were
observed in general health (P<0.05), bodily pain (P<0.0001), physical functioning
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(P<0.0001), vitality (P<0.0001), and health distress (P<0.05). After adjustments for
confounders high mean Physical Health Summary (PHS) scores were observed in age
groups <36 and secondary plus education attendants of the two study groups while, high
Mental Health Summary (MHS) scores were related to age less than 36, males,
secondary education attendants, employed and high income groups of both PLWHA on
HAART and their neighbors. In multivariate analysis education was the only predictor of
physical and mental health summary scoring in PLWHA on HAART and their neighbors.
In conclusion, patient-reported measures may provide a feasible and reliable method to
assess the problems and clinical progress of PLWHA on HAART. Intervention strategies
to improve the health-related quality of life of PLWHA on HAART like educational
opportunity to allivate employment and economic problems are recommended.
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Keywords
Measuring the Quality Of Life (QOL)