The Impact of Chronic Pulmonary Aspergillosis Co-infection on the Health-Related Quality of Life of Patients with Pulmonary Tuberculosis in Uganda

Martha Namusobya; Felix Bongomin; John Mukisa; Charles Batte; William Kane Olwit; Joshua Rhein; Christine Sekaggya-Wiltshire; Shailendra Prasad

doi:10.1007/s11046-023-00741-1

The Impact of Chronic Pulmonary Aspergillosis Co-infection on the Health-Related Quality of Life of Patients with Pulmonary Tuberculosis in Uganda

Mycopathologia. 2023 Oct;188(5):713-720. doi: 10.1007/s11046-023-00741-1. Epub 2023 May 17.

Authors

Martha Namusobya¹, Felix Bongomin², John Mukisa³, Charles Batte⁴, William Kane Olwit⁵, Joshua Rhein⁶, Christine Sekaggya-Wiltshire⁷, Shailendra Prasad⁶

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. martharynam@gmail.com.
² Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
³ Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
⁴ Department of Epidemiology and Biostatistics, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
⁵ Department of Radiology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
⁶ Centre for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA.
⁷ Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.

PMID: 37195546
DOI: 10.1007/s11046-023-00741-1

Abstract

Background: Both pulmonary tuberculosis (PTB) and chronic pulmonary aspergillosis (CPA) significantly affect health-related quality of life (HR-QoL). We aimed to determine the impact of CPA co-infection on the HR-QoL of Ugandans with PTB.

Methods: We conducted a prospective study as part of a larger study among participants with PTB with persistent pulmonary symptoms after 2 months of anti-TB treatment at Mulago Hospital, Kampala, Uganda between July 2020 and June 2021. HR-QoL was assessed using St. George Respiratory Questionnaire (SGRQ) at enrollment and at the end of PTB treatment (4 months apart). SGRQ scores range from 0 to 100, with higher score representing a poorer HR-QoL.

Results: Of the 162 participants enrolled in the larger study, 32 (19.8%) had PTB + CPA and 130 (80.2%) had PTB. The baseline characteristics of the two groups were comparable. Regarding overall health, a higher proportion of the PTB group rated their HR-QoL as "very good" compared to those who had PTB + CPA (68 [54.0%] versus 8 [25.8%]). At enrollment, both groups had comparable median SGRQ scores. However, at follow up, the PTB group had statistically significantly better SGRQ scores (interquartile range); symptoms (0 [0-12.4] versus 14.4 [0-42.9], p < 0.001), activity ((0 [0-17.1] versus 12.2 [0-35.5], p = .03), impact (0 [0-4.0] versus 3.1 [0-22.5], p = 0.004), and total scores ((0 [0-8.5] versus 7.6[(0-27.4], p = 0.005).

Conclusion: CPA co-infection impairs HR-QoL of people with PTB. Active screening and management of CPA in patients with PTB is recommended to improve HR-QoL of these individuals.

Keywords: Chronic pulmonary aspergillosis; Persistent symptoms; Pulmonary tuberculosis; Quality of life; St. George Respiratory Questionnaire; Uganda.

Abstract

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