Quality of life among perinatally HIV-affected and HIV-unaffected school-aged and adolescent Ugandan children: a multi-d
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Quality of life among perinatally HIV-affected and HIVunaffected school-aged and adolescent Ugandan children: a multidimensional assessment of wellbeing in the post-HAART era A. K. Nkwata1 • S. K. Zalwango2 • F. N. Kizza3 • J. N. Sekandi1,4 J. Mutanga1 • M. Zhang1 • P. M. Musoke5,6 • A. E. Ezeamama7
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Accepted: 16 May 2017 Ó Springer International Publishing Switzerland 2017
Abstract Objective To examine quality of life (QOL) in perinatally HIV-infected (PHIV) or HIV-exposed uninfected (PHEU) vs. healthy HIV-unexposed uninfected (HUU) children during school-age/adolescence. Methods PHIV infection was diagnosed via DNA PCR. Current HIV status was confirmed by HIV rapid diagnostic test. Three HIV groups were defined: PHIV, PHEU, and HUU. QOL was assessed with proxy and self-report versions of the PedsQLTM 4.0 instrument at 6–18 years of age. QOL scores ranged from zero (least QOL) to 100 (highest QOL) in the following dimensions: combined QOL inventory (CQOLI), multi-dimensional vigor (MDV),
Electronic supplementary material The online version of this article (doi:10.1007/s11136-017-1597-2) contains supplementary material, which is available to authorized users. & A. E. Ezeamama [email protected] 1
Department of Epidemiology and Biostatistics, The University of Georgia, Athens, GA, USA
2
Directorate of Public Health and Environment, Kampala Capital City Authority, Kampala, Uganda
3
Division of Health Protection, Office of HIV, Georgia Department of Public Health, Atlanta, GA, USA
4
School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
5
Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
6
Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
7
Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
general wellbeing (GWB), present functioning, and general cognitive functioning (CF). Multivariable linear regression models estimated HIV-related percent differences (b) in QOL scores and 95% confidence intervals (CI). Findings Compared to HUU CQOLI deficits ranged from 6.5 to 9.2% (95% CI -15.4, -1.6), GWB deficit ranged from 6.5 to 10.5% (95% CI -16.0, -1.3), MDV deficit ranged from 6.8 to 11.6% (95% CI -14.5, 0.9), and CF deficit ranged from 9.7 to 13.1% for PHIV children. QOL deficits of similar magnitude and direction in most domains were observed for PHIV compared to PHEU. However, self-reported indicators of GWB (b = -3.5; 95% CI -9.0, 2.0) and present functioning (b = 4.0; 95% CI -4.6, 12.5) were similar for PHIV compared to PHEU. QOL scores were generally similar for PHEU compared to HUU. Conclusion PHEU and HUU had similar QOL profile but PHIV predicted sustained deficits in multiple QOL domains. PHIV and PHEU children were similar with respect to general wellbeing and present functioning. Psychosocial and scholastic interventions in combination with HIV care are likely to improve QOL in PHIV. K
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