Schistosomiasis, Upper Gastrointestinal Bleeding, and Health Related Quality of Life Measurements in Rural Africa
Loading...
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Research Square
Abstract
Health related quality of life (HRQOL) measurements, which include disability weights, are
important endpoints of health care delivery. These measurements are scarce for patients with upper
gastrointestinal bleeding (UGIB) in rural sub-Saharan Africa (SSA) where schistosomiasis is endemic.
Methods and materials In 2014, we studied HRQOL measurements among patients with UGIB in SSA
where schistosomiasis is endemic. Participants included adult inpatients and outpatients with a history
of UGIB at a primary health facility. We measured HRQOL using the EuroQoL 5-dimension (EQ-VAS/EQ5D)
instrument and derived disability weights from EQ-VAS and EQ5D measurements. We profiled each
participant’s medical history, physical examination, laboratory tests, imaging, and endoscopy findings.
These were summarized through descriptive and inferential statistics.
Results We studied 107 participants with a median age of 45 years. All participants experienced ≥1
lifetime episode of UGIB, 60% were females, while 22% had acute severe UGIB requiring admission, 98%
hepatic schistosomiasis, 90% splenomegaly, 80% had esophageal varices, and 20% had peptic ulcers.
Most (80%) had ever received praziquantel for schistosomiasis. No participant had ever had an
endoscopy for UGIB or received propranolol for prevention of recurrent variceal UGIB. Measures of the 5
dimensions of health revealed a large proportion of participants had problems related to self-care (76%),
anxiety/depression (88%), and pain/discomfort (89%). Few participants had problems with
mobility(37%). The mean/median EQ-VAS derived disability weights and EQ5D derived disability weights
were 0.38/0.30 and 0.38/0.34, respectively. Participants with ascites, acute UGIB, and severe anemia were
found to have the highest EQ-VAS and EQ5D median disability weights. At linear regression age, female
gender, ascites, and acute UGIB predicted EQ-VAS derived disability weights [F(4,100)=9.35, p<0.0000,Rsquared
=0.27] and EQ5D derived disability weights [F(4,100)=23.24, p<0.0000, R-squared =0.44]. Within
these models, all four factors were significantly predicted higher disability weights, P-value <0.05.
Conclusions In our study, older age, female gender, those with ascites or acute UGIB had the highest
disability weights, and the greatest probability of having higher disability weights among patients with a
history of UGIB where schistosomiasis is endemic. These findings are unique and improve the definitions
of different health states among patients with UGIB and schistosomiasis.
Description
Keywords
Health related quality of life measurements, Disability weights, Upper gastrointestinal bleeding, Schistosomiasis, EQ-5D/EQ-VAS
Citation
Opio, C. K., Kazibwe, F., Rejani, L., Kabatereine, N. B., & Ocama, P. (2020). Schistosomiasis, Upper Gastrointestinal Bleeding, and Health Related Quality of Life Measurements in Rural Africa. https://doi.org/10.21203/rs.3.rs-42011/v1