Health-Related Quality of Life and Associated Factors Among Adult HIV Mono-Infected and TB/HIV Co-Infected Patients in Public Health Facilities in Northeast Ethiopia: A Comparative Cross-Sectional Study

Figures & data

Figure 1 Conceptual framework for factors associated with HRQOL of HIV mono-infected and TB/HIV co-infected people from different literatures.^{11,14–16,19–41}

Table 1 Sociodemographic, Personal, Behavioral and Medical Characteristics of the Study Population Northeast Ethiopia, 2019

Variables	HIV (n=434)	TB/HIV (n=143)
	n (%)	n (%)
Sociodemographic characteristics
Type of facility
Specialized hospital	197 (45.40)	49 (34.27)
General hospital	94 (21.65)	26 (18.18)
Health center	143 (32.95)	68 (47.55)
Age in years, Mean (SD)	37.27 (8.86)	36.27 (7.44)
Sex
Female	267 (61.52)	79 (55.24)
Male	167 (38.48)	64 (44.76)
Marital status
Married	249 (57.37)	84 (58.74)
Unmarried	185 (42.63)	59 (41.26)
Religion
Muslim	228 (52.53)	68 (47.55)
Christian	206 (47.47)	75 (52.45)
Occupational status
Employed	137 (31.57)	58 (40.56)
Unemployed	120 (27.65)	37 (25.87)
Merchant	78 (17.97)	14 (9.79)
Daily laborer	60 (13.82)	17 (11.89)
Farmer	39 (8.99)	17 (11.89)
Residence
Urban	374 (86.18)	118 (82.52)
Rural	60 (13.82)	25 (17.48)
Educational status
Uneducated	109 (25.12)	40 (27.97)
Primary	115 (26.50)	36 (25.17)
Secondary	144 (33.18)	46 (32.17)
Higher	66 (15.21)	21 (14.69)
Ethnicity
Amhara	414 (95.39)	132 (92.31)
Tigre	13 (3.00)	4 (2.80)
Oromo	6 (1.38)	6 (4.20)
Other	1 (0.23)	1 (0.70)
Wealth index
Low	144 (33.18)	58 (40.56)
Moderate	148 (34.10)	34 (23.78)
High	142 (32.72)	51 (35.66)
Personal characteristics
PSCR
Not at all	159 (36.64)	63 (44.06)
A little	70 (16.13)	26 (18.18)
Moderately	157 (36.18)	46 (32.17)
Very much	48 (11.06)	8 (5.59)
EWTF
Not at all	151 (34.79)	46 (32.17)
A little	99 (22.81)	24 (16.78)
Moderately	112 (25.81)	47 (32.87)
Very much	72 (16.59)	26 (18.18)
Depression status
Depressive	36 (8.29)	60 (41.96)
Not depressive	398 (91.71)	83 (58.04)
Stigma scale
Stigmatized	180 (41.47)	84 (58.74)
Not stigmatized	254 (58.53)	59 (41.26)
Behavioral characteristics
Alcohol intake
Hazardous drinker	153 (35.25)	43 (30.07)
Non-hazardous drinker	281 (64.75)	100 (69.93)
Smoking status
Smoker	16 (3.69)	8 (5.59)
Nonsmoker	418 (96.31)	135 (94.41)
Medical characteristics
Duration since the disease diagnosed in months
Median (IQR)	74 (72)	85 (72)
WHO clinical stage
Stage I	386 (88.94)	NA
Stage II	42 (9.68)	NA
Stage III	6 (1.38)	98 (68.53)
Stage IV	NA	45 (31.47)
CD4 count
Median (IQR)	463 (300)	360 (183)
Types of TB disease
HIV/SMEAR +VE PTB	NA	69 (48.25)
HIV/EPTB		30 (20.98)
HIV/MDR TB		23 (16.08)
HIV/SMEAR -VE PTB		19 (13.29)
HIV/XDR TB		2 (1.40)
Type of ART drug that the participant took
1C	79 (18.20)	25 (17.48)
1D	63 (14.52)	19 (13.29)
1E	226 (52.07)	87 (60.84)
1F	64 (14.75)	5 (3.50)
OTHER	2 (0.46)	7 (4.90)

Abbreviations: PSCR, possibility of sharing common resources with other people; EWTF, extent to which worry about taking care of the family when passed away; 1C, AZT-3TC-NVP; 1D, AZT-3TC-EFV; 1E, TDF-3TC-EFV; 1F, TDF-3TC-NVP; NA, not applicable.

Table 2 Comparison Between Domains of Health-Related Quality of Life of TB/HIV and HIV Patients, Northeast Ethiopia, 2019

Quality of Life Domains	TB/HIV (n=143) Mean (±SD)	HIV (n=434) Mean (±SD)	p-value
Physical domain	46.59 (16.81)	63.9 (16.99)	0.001
Psychological domain	48.53 (15.46)	65 (15.45)	0.001
Level of independence	42.65 (19.61)	60.5 (17.89)	0.001
Social relation	43.53 (18.73)	59 (18.51)	0.001
Environmental domain	39.31 (14.23)	56.4 (14.08)	0.001
Spiritual domain	51.26 (20.17)	63.9 (20.37)	0.001
Depressive symptoms	10.34 (5.18)	5.5 (4.18)	0.001
Stigma score	3.33 (2.18)	2.47 (1.95)	0.001

Table 3 Factors Associated with the Physical and Psychological Domains of the HRQOL in HIV Mono-Infected and TB/HIV Co-Infected Patients in Public Health Facilities, Northeast Ethiopia, 2019

Variables	Category	Domains
		Physical Domain		Psychological Domain
		HIV (n=434)	TB/HIV (n=143)	HIV (n=434)	TB/HIV (n=143)
		Β (95% CI)	β (95% CI)	Β (95% CI)	Β (95% CI)
Age (mean =35)	>35	NA	−1.34 (−7.40, 4.72)	4.3 (1.39, 7.14) *	NA
Sex	Female	−1.8 (−5.15, 1.63)	NA	−2.56 (−5.59, 0.47)	−3.83 (−9.19, 1.54)
Marital status	Married	2.45 (−0.72, 5.62)	NA	1.86 (−0.88, 4.61)	3.50 (−1.87, 8.86)
Occupational status	Employed	4.30 (0.68, 7.91) *	NA	1.8 (−1.38, 4.50)	NA
Residence	Urban	2.16 (−2.80, 7.11)	NA	1.8 (−2.67, 6.18)	NA
Educational status	Educated	4.56 (0.54, 8.58)*	7.72 (1.20, 14.23) *	5.61 (1.97, 9.25) *	4.43 (−1.50, 10.36)
PSCR	Not at all	0	0	NA	0
	A little	3.18 (−1.49, 7.85)	8.91 (1.23, 16.59) *		5.97 (−1.30, 13.24)
	Moderately	5.14 (1.50, 8.77) *	1.97 (−4.35, 8.30)		0.44 (−5.71, 6.59)
	Very much	−0.90 (−6.45, 4.65)	0.18 (−12.09, 12.45)		−3.30 (−14.93, 8.33)
EWTF	Not at all	3.66 (−1.18, 8.50)		NA	−4.83 (−12.62, 2.96)
	A little	1.47 (−3.72, 6.67)	NA		−2.77 (−11.10, 5.56)
	Moderately	1.65 (−3.36, 6.67)			−1.40 (−8.98, 6.19)
	Very much	0			0
Duration (median=80)	>80	NA	NA	0.05 (−2.83, 2.93)	−3.32 (−8.43, 1.78)
WHO stage	I	11 (−2.23, 24.27)		−0.5 (−12, 11)
	II	11 (−3.17, 24.83)	NA	3.6 (−8.54, 15.77)	NA
	III	0		0
	IV	NA		NA
Depression symptoms	Depressive	−8.9 (−14.64, −3.20) *	−3.73 (−9.39, 1.93)	−12 (−16.84, −6.68)*	−3.53 (−8.82, 1.77)
Stigma scale	Stigmatized	−2.69 (−5.88, 0.50)	−1.70 (−7.68, 4.28)	NA	−5.78 (−11.31, −0.25) *
Alcohol intake	HAD	0.87 (−2.79, 4.54)	NA	−1.99 (−5.23, 1.25)	NA
Smoking status	Smoker	−5.6 (−14.1, 2.87)	NA	NA	NA
Wealth index	Low	0	0	0	0
	Middle	3.50 (−0.23, 7.23)	−0.56 (−7.57, 6.46)	0.21 (−3.14, 3.57)	0.71 (−5.87, 7.28)
	High	5.29 (1.53, 9.05) *	4.13 (−2.85, 11.11)	3.52 (0.17, 6.88)*	2.92 (−3.34, 9.17)
Adjusted R^2		0.1642	0.1065	0.1811	0.1096

Note: *Statistically significant value at p < 0.05.

Abbreviations: NA, not applicable; PSCR, possibility of sharing common resources; EWTF, extent to which worry about taking care of family when passed away; HAD, hazardous alcohol drinker.

Table 4 Factors Associated with the Level of Independence and Social Relation Domains of the HRQOL in HIV Mono-Infected and TB/HIV Co-Infected Patients in Public Health Facilities, Northeast Ethiopia, 2019

Variables	Category	Domains
		Level of Independence Domain		Social Relation Domain
		HIV (n=434)	TB/HIV (n=143)	HIV (n=434)	TB/HIV (n=143)
		β (95% CI)	β (95% CI)	β (95% CI)	β (95% CI)
Sex	Female	−5.48 (−8.96, −1.99) *	−2.52 (−9.08, 4.04)	−1.28 (−4.84, 2.27)	0.33 (−5.98, 6.65)
Marital status	Married	2.47 (−0.88, 5.82)	−3.42 (−10.06, 3.21)	6.67 (3.24, 10.11) *	3.21 (−2.79, 9.21)
Occupational status	Employed	2.00 (−1.81, 5.80)	NA	0.87 (−3.01, 4.75)	NA
Residence	Urban	NA	−9.43 (−18.40, −0.46) *	NA	7.63 (−0.87, 16.13)
Educational status	Educated	4.86 (1.08, 8.63) *	NA	3.93 (0.08, 7.78) *	10.6 (3.70, 17.51) *
EWTF	Not at all	3.22 (−1.65, 8.10)		4.50 (−0.48, 9.47)
	A little	4.35 (−0.88, 9.58)		4.26 (−1.08, 9.59)
	Moderately	1.48 (−3.52, 6.48)	NA	2.99 (−2.11, 8.08)	NA
	Very much	0		0
CD4 count (median=439)	>439	NA	−4.41 (−11.45, 2.63)	NA	0.62 (−5.98, 7.21)
Depression symptoms	Depressive	−4.27 (−10.28, 1.73)	−4.77 (−11.43, 1.88)	−12.8 (−18.96, −6.64) *	−10 (−16.3, −4.39) *
Stigma scale	Stigmatized	NA	−0.38 (−7.14, 6.39)	−5.14 (−8.62, −1.66) *	NA
Smoking status	Smoker	NA	NA	NA	4.7 (−8.47,17.84)
Wealth index	Low	0	0	0	0
	Middle	3.93 (−0.02, 7.88)	2.60 (−5.58,10.77)	2.64 (−1.40, 6.68)	0.24 (−7.21,7.69)
	High	9.11 (5.11, 13.11) *	10.41 (2.00, 18.8) *	4.92 (0.84, 9.01) *	9.04 (1.52, 16.55)*
Adjusted R^2		0.1263	0.1305	0.1429	0.1760

Note: *Statistically significant value at p < 0.05.

Abbreviations: NA, not applicable; EWTF, extent to which worry about taking care of family when passed away.

Table 5 Factors Associated with the Environmental and Spiritual Domains of the HRQoL in HIV Mono-Infected and TB/HIV Co-Infected Patients in Public Health Facilities, Northeast Ethiopia, 2019

Variables	Category	Domains
		Environmental Domain		Spiritual Domain
		HIV (n=434)	TB/HIV (n=143)	HIV (n=434)	TB/HIV (n=143)
		β (95% CI)	β (95% CI)	β (95% CI)	β (95% CI)
Age (mean= 35)	>35	NA	−0.51 (−5.19, 4.18)	2.10 (−1.44, 5.64)	NA
Sex	Female	NA	0.18 (−4.36, 4.72)	NA	−5.3 (−12.17,1.59)
Residence	Urban	4.99 (1.24, 8.75) *	NA	NA	NA
Educational status	Educated	4.61 (1.59, 7.63)*	9.29 (4.08, 14.49) *	NA	NA
Possibility of sharing common resources	Not at all		0	0
	A little	NA	0.27 (−5.56, 6.10)	0.16 (−5.04, 5.35)	NA
	Moderately		−4.70 (−9.46, 0.05)	1.37 (−2.70, 5.45)
	Very much		−6.95 (−16.22, 2.32)	1.77 (−4.26, 7.79)
Worrying about the family if one passes away due to the disease	Not at all	7.24 (3.83, 10.64) *
	A little	6.60 (2.88, 10.31) *	NA	NA	NA
	Moderately	2.36 (−1.20, 5.92)
	Very much	0
Duration (Median=80)	>80	NA	−2.45 (−6.63, 1.73)	5.16 (1.47, 8.85) *	NA
WHO stage	I	NA	NA	25.5 (10.59, 40.41) *	NA
	II			34.2 (18.28, 50.13) *	NA
	III			0	10.9 (0.41, 21.29)*
	IV			NA	0
CD4 count (median=439)	>439	NA	−0.75 (−5.39, 3.88)	NA	NA
Depression symptoms	Depressive	−10.2 (−14.48, −5.94) *	−4.39 (−8.71, −0.06) *	−6.98 (−13.35, −0.62) *	−5.8 (−12.5, 0.90)
Stigma scale	Stigmatized	−2.55 (−4.98, −0.13) *	−5.09 (−9.56, −0.63) *	−11.4 (−14.99, −7.66) *	NA
Alcohol intake	HAD	NA	NA	−1.43 (−5.58, 2.73)	NA
Smoking status	Smoker	NA	−4.51 (−4.71, 13.73)	0.44 (−8.87, 9.75)	NA
Wealth index	Low	0	0	0	0
	Middle	4.19 (1.35, 7.02) *	5.21 (−0.01, 10.43)	−0.46 (−4.68, 3.76)	9.77 (0.87, 18.68)*
	High	10.4 (7.56, 13.26) *	12.12 (6.8, 17.36) *	−3.19 (−7.39, 1.01)	1.99 (−5.79, 9.78)
Adjusted R^2		0.287	0.307	0.2300	0.0779

Note: *Statistically significant value at p < 0.05.

Abbreviations: NA, not applicable; HAD, hazardous alcohol drinker.

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