Mental, physical, and respiratory health in people with tuberculosis in Southern Africa: a multi-country cohort analysis

作者：Nicolas Banholzer, Guy Muula, Fiona Mureithi, Denise Evans, Jacqueline Huwa, Idiovino Rafael, Cordelia Kunzekwenyika, Nelly Jinga, Amina Fernando, Agness Thawani, Remo Schmutz, Carolyn Bolton‐Moore, Gunar Günther, Matthias Egger, Andreas D. Haas, Annika C. Sweetland, Marie Ballif, Lukas Fenner, IeDEA Southern Africa (IeDEA-SA) · 发表于：BMC Medicine · 年份：2025 · DOI：10.1186/s12916-025-04321-6 · 被引用次数：4 · 研究领域：Tuberculosis Research and Epidemiology、Pneumocystis jirovecii pneumonia detection and treatment、Infectious Diseases and Tuberculosis

BACKGROUND: Tuberculosis (TB) affects people's quality of life (QoL). We prospectively monitored physical and mental health-related QoL over time in people with TB in the Southern African region with a high HIV and TB burden. METHODS: Adults aged ≥ 15 years with pulmonary TB were enrolled in five cohorts in Malawi, Mozambique, South Africa, Zambia, and Zimbabwe from October 2022 to September 2024. We assessed six QoL outcomes using validated instruments at the start (baseline), end of treatment, and 6 months post-treatment: symptoms of depression (PHQ-9), mental and physical health (SF-12 mental, SF12-MC, SF-12 physical component, SF12-PC), physical fitness (6-Minute Walk Test, 6MWT; 1-min Sit-To-Stand Test, STST), and respiratory health (Saint-George-Respiratory-Questionnaire, SGRQ). Missing QoL scores were imputed with multivariate imputation by chained equations. We compared the proportion of participants with impaired QoL, defining impairment based on outcome-specific cut-off values. We also estimated changes in QoL scores and examined their associations with baseline characteristics using Bayesian multivariable regression models. RESULTS: We included 1438 participants with a median follow-up of 344 days (interquartile range [IQR] 183-373). The median age was 39 years (IQR 30-50); 67% were male, and 39% living with HIV. At baseline, 49% had symptoms of depression, 73% had impaired mental health and 92% impaired physical health-related QoL, 68-74% had reduced physical fitn...