Change in Health-Related Quality of Life among Pulmonary Tuberculosis Patients at Primary Health Care Settings in South Africa: A Prospective Cohort Study

PLoS One. 2016 May 3;11(5):e0151892. doi: 10.1371/journal.pone.0151892. eCollection 2016.


Introduction: Pulmonary tuberculosis (TB) remains a major public health challenge in South Africa. However, little attention is paid to the impact of health related quality of life (HRQL) among TB patients at the beginning and at the end of TB treatment. This study assesses factors associated with HRQL among tuberculosis patients in three high risk provinces in South Africa.

Methods: A prospective cohort study was conducted at primary health care settings. Patients completed the HRQL social functioning (SF)-12 health survey. Comparison of Physical Health Summary Score (PCS) and Mental Health Summary Score (MCS) was assessed at 6 months after treatment. Generalized estimating equations (GEEs) were used to examine the factors associated with changes in HRQL.

Results: In all patients, after 6 months of treatment there was a significant improvement in HRQL with the biggest increase in the PCS. A higher educational qualification had a strong significant positive effect on the mental HRQL. Psychological distress showed a significant negative association with physical and mental HRQL after six months. Permanent residence showed a significant positive association with mental HRQL among TB patients compared to those living in shack/traditional dwellings. Rating ones health as being good and fair/poor was significantly associated with poor physical HRQL. Twenty drinks or more in the past month had a significant negative effect on the physical HRQL.

Conclusion: The findings suggest that programmes targeted at improving TB treatment success should have specific interventions for patients with low educational background, impoverished households/communities and those with hazardous or harmful alcohol use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care*
  • Prospective Studies
  • Quality of Life*
  • South Africa / epidemiology
  • Tuberculosis, Pulmonary / epidemiology
  • Tuberculosis, Pulmonary / physiopathology*
  • Young Adult

Grants and funding

The Department of Health in South Africa funded this study through a tender “NDOH: 21/2010-2011 Implementation and monitoring of Screening and Brief Intervention for alcohol use disorders among Tuberculosis patients” that was awarded the HSRC. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.