A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey

Vo, Luan Nguyen Quang, Forse, Rachel, Codlin, Andrew James, Huynh, Huy Ba, Wiemers, Anja Maria Christine, Creswell, Jacob, Garg, Tushar, Dang, Thi Minh Ha, Nguyen, Lan Huu, Nguyen, Hoa Binh, Van Dinh, Luong, Nguyen, Nhung Viet, Wingfield, Tom ORCID: https://orcid.org/0000-0001-8433-6887, Sidney Annerstedt, Kristi, Shedrawy, Jad and Lönnroth, Knut (2025) 'A life that’s worth living – measuring health-related quality of life among people treated for tuberculosis in Viet Nam: a longitudinal EQ-5D-5L survey'. Health and quality of life outcomes, Vol 23, Issue 1, p. 43.

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Abstract

Background
In many settings, Tuberculosis (TB) represents a catastrophic life event that substantially impairs a person’s Health-Related Quality of Life (HRQoL). We aimed to measure HRQoL among people with TB in Viet Nam at initiation and throughout treatment.

Methods
This study took place in four provinces from Oct-2020 to Sep-2022. Persons initiated on TB treatment were consecutively recruited across three pathways to access care: passive case finding (NTP); active case finding (ACF); and private sector engagement (PPM). We conducted the EuroQol–5-Dimension–5-Level (EQ-5D-5L) survey during the intensive, continuation, and post-treatment phase. We described participant characteristics, assessed the survey’s psychometric properties, and calculated utility indexes using a Vietnamese value set. We reported these alongside visual analog scale (EQ-VAS) scores and EQ-5D-5L dimensions by treatment stage, care pathway and other participant characteristics. Mixed-effect Tobit models were fitted to identify relevant associations with HRQoL, which we compared to general population benchmarks.

Results
We recruited 585 participants (23.6% female) with a median age of 51 years. EQ-5D-5L dimensions at baseline showed that 53.8% experienced pain/discomfort and 35.0% felt anxiety/depression, while 33.8%, 30.4%, and 9.6% reported problems with carrying out usual activities, mobility, and self-care, respectively. The mean utility index was 0.83 (95% confidence interval: [0.82, 0.85]) and mean EQ-VAS was 67.1 (95%CI: [65.6, 68.6]). Post-treatment, HRQoL improved significantly on all dimensions and composite measures. While utility indexes were at parity with general population benchmarks (0.90; 95%CI: [0.89, 0.92] vs. 0.91), self-reported EQ-VAS scores remained significantly lower (79.4; 95%CI: [78.1, 80.6] vs. 87.4). HRQoL was higher at baseline in the ACF versus the NTP cohorts on utility index (0.87 vs. 0.82; p = 0.003) and EQ-VAS score (70.4 vs. 65.5; p = 0.015). The EQ-5D-5L tool demonstrated moderate to high validity on Cronbach’s alpha (0.75 ≤ α ≤ 0.84) and Spearman’s rho (0.4679 ≤ ρ0 ≤ 0.5651) across treatment stages and various known groups.

Conclusion
TB significantly impairs HRQoL among affected Vietnamese people. While treatment partially remedies these impairments, they may persist post-TB. Hence, physical, psychological and social rehabilitation during and after therapy should receive more attention. We found evidence that ACF may mitigate TB-related declines in HRQoL, but tailored studies are needed to substantiate these findings.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 305 Mental health of special population groups WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1186/s12955-025-02369-9
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	01 May 2025 13:13
Last Modified:	01 May 2025 13:13
URI:	https://archive.lstmed.ac.uk/id/eprint/26599

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