HIV, multimorbidity, and health-related quality of life in rural KwaZulu-Natal, South Africa: A population-based study
Rattachement africain : us, Afrique du Sud, gb. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Health-related quality of life (HRQoL) assesses the perceived impact of health status across life domains. Although research has explored the relationship between specific conditions, including HIV, and HRQoL in low-resource settings, less attention has been paid to the association between multimorbidity and HRQoL. In a secondary analysis of cross-sectional data from the Vukuzazi ("Wake up and know ourselves" in isiZulu) study, which identified the prevalence and overlap of non-communicable and infectious diseases in the uMkhanyakunde district of KwaZulu-Natal, we (1) evaluated the impact of multimorbidity on HRQoL; (2) determined the relative associations among infectious diseases, non-communicable diseases (NCDs), and HRQoL; and (3) examined the effects of controlled versus non-controlled disease on HRQoL. HRQoL was measured using the EQ-5D-3L, which assesses overall perceived health, five specific domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and three levels of problems (no problems, some problems, and extreme problems). Six diseases and disease states were included in this analysis: HIV, diabetes, stroke, heart attack, high blood pressure, and TB. After examining the degree to which number of conditions affects HRQoL, we estimated the effect of joint associations among combinations of diseases, each HRQoL domain, and overall health. Then, in one set of ridge regression models, we assessed the relative impact of HIV, diabetes, stroke, heart attack, high blood pressure, and tuberculosis on the HRQoL domains; in a second set of models, the contribution of treatment (controlled vs. uncontrolled disease) was added. A total of 14,008 individuals were included in this analysis. Having more conditions adversely affected perceived health (r = -0.060, p<0.001, 95% CI: -0.073 to -0.046) and all HRQoL domains. Infectious conditions were related to better perceived health (r = 0.051, p<0.001, 95% CI: 0.037 to 0.064) and better HRQoL, whereas non-communicable diseases (NCDs) were associated with worse perceived health (r = -0.124, p<0.001, -95% CI: 0.137 to -0.110) and lower HRQoL. Particular combinations of NCDs were detrimental to perceived health, whereas HIV, which was characterized by access to care and suppressed viral load in the large majority of those affected, was counterintuitively associated with better perceived health. With respect to disease control, unique combinations of uncontrolled NCDs were significantly related to worse perceived health, and controlled HIV was associated with better perceived health. The presence of controlled and uncontrolled NCDs was associated with poor perceived health and worse HRQoL, whereas the presence of controlled HIV was associated with improved HRQoL. HIV disease control may be critical for HRQoL among people with HIV, and incorporating NCD prevention and attention to multimorbidity into healthcare strategies may improve HRQoL.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- HIV, multimorbidity, and health-related quality of life in rural KwaZulu-Natal, South Africa: A population-based study
- Date Crossref
- 21/02/2024
- Éditeur
- Public Library of Science (PLoS)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Boston University Department of Psychological and Brain Sciences pays non établi dans la noticeUniversité ou école supérieure
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Massachusetts General Hospital Department of Psychiatry pays non établi dans la noticeÉtablissement de santé
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Fenway Health pays non établi dans la noticeÉtablissement de santé
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University of the District of Columbia pays non établi dans la noticeUniversité ou école supérieure
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Harvard University pays non établi dans la noticeUniversité ou école supérieure
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Africa Health Research Institute KwaZulu-Natal, Afrique du Sud (code pays fourni par la source)Structure de recherche
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Columbia University pays non établi dans la noticeUniversité ou école supérieure
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University College London Division of Infection and Immunity pays non établi dans la noticeUniversité ou école supérieure
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University of KwaZulu-Natal University of KwaZulu-Natal, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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London School of Hygiene & Tropical Medicine pays non établi dans la noticeUniversité ou école supérieure
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South African Medical Research Council Afrique du Sud (code pays fourni par la source)Institution
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South African Population Research Infrastructure Network Durban, Afrique du Sud (code pays fourni par la source)Organisme public
Department of Psychological and Brain Sciences — Boston University, Department of Psychiatry — Massachusetts General Hospital et Fenway Health, avec 9 autres affiliations. Pays d’affiliation : Afrique du Sud.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.