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.
Bibliographical noteFunding Information:
Research reported in this publication was supported by the Fogarty International Center and National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health under grant #D43TW009345 awarded to the Northern Pacific Global Health Fellows Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also supported by the Makerere University Non-Communicable Diseases (MAKNCD) Research Training Program that is supported by the Fogarty International Centre of the National Institutes of Health under Award Number D43TWO11401. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
We thank the MNRH TB unit for hosting the study. We’re grateful to the study team based there (Betty Namara, Jane Oyeru, Sam Nyole, and Esther Mbabazi) who were key in participant identification, recruitment, and retention. We also thank and acknowledge the Infectious Diseases Institute (IDI) Translational Laboratory team (Richard Kwizera, Emmanuel Mande, and Claudine Mukashyaka) for contributing to the baseline study with CPA diagnostics. An oral abstract of part of this work was presented at the 10th Trends in Medical Mycology (TIMM) Conference that happened in October 2021 in Aberdeen, Scotland.
© 2023, The Author(s), under exclusive licence to Springer Nature B.V.
- Chronic pulmonary aspergillosis
- Persistent symptoms
- Pulmonary tuberculosis
- Quality of life
- St. George Respiratory Questionnaire
PubMed: MeSH publication types
- Journal Article