Namusobya Martha, Bongomin Felix, Mukisa John, Batte Charles, Olwit William Kane, Rhein Joshua, Sekaggya-Wiltshire Christine, Prasad Shailendra
Makerere University CHS: Makerere University College of Health Sciences.
Gulu University Faculty of Medicine.
Res Sq. 2023 Jan 13:rs.3.rs-2389854. doi: 10.21203/rs.3.rs-2389854/v1.
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 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, 32 (19.8%) had CPA + PTB and 130 (80.2%) had PTB only. The baseline characteristics of the two groups were comparable. Regarding overall health, a higher proportion of the PTB only group rated their HR-QoL as "very good" compared to those who had both TB and CPA (68 (54.0%) 8 (25.8%)). At enrollment, both groups had comparable median SGRQ scores. However, at follow up, the PTB only group had statistically significantly better SGRQ scores (interquartile range); symptoms (0 (0 - 12.4) 14.4 (0 - 42.9), p < 0.001), activity ((0 (0 - 17.1) 12.2 (0 - 35.5), p = .03), impact (0 (0 - 4.0) 3.1 (0 - 22.5), p = 0.004), and total scores ((0 (0 - 8.5) 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.
肺结核（PTB）和慢性肺曲霉病（CPA）均会显著影响健康相关生活质量（HR-QoL）。我们旨在确定CPA合并感染对乌干达PTB患者HR-QoL的影响。方法：2020年7月至2021年6月期间，我们在乌干达坎帕拉穆拉戈医院对接受抗结核治疗2个月后仍有持续肺部症状的PTB患者进行了一项前瞻性研究。在入组时和PTB治疗结束时（相隔4个月）使用圣乔治呼吸问卷（SGRQ）评估HR-QoL。SGRQ评分范围为0至100，分数越高表示HR-QoL越差。结果：在162名入组参与者中，32名（19.8%）患有CPA+PTB，130名（80.2%）仅患有PTB。两组的基线特征具有可比性。在总体健康方面，仅患有PTB的组中，将其HR-QoL评为“非常好”的比例高于同时患有结核病和CPA的组（68名（54.0%）对8名（25.8%））。入组时，两组的SGRQ中位数得分具有可比性。然而，在随访时，仅患有PTB的组的SGRQ得分在统计学上显著更好（四分位间距）；症状（0（0 - 12.4）对14.4（0 - 42.9），p < 0.001）、活动（（0（0 - 17.1）对12.2（0 - 35.5），p = 0.03）、影响（0（0 - 4.0）对3.1（0 - 22.5），p = 0.004）和总分（（0（0 - 8.5）对7.6（0 - 27.4），p = 0.005）。结论：CPA合并感染会损害PTB患者的HR-QoL。建议对PTB患者进行CPA的积极筛查和管理，以改善这些个体的HR-QoL。
