Measuring health related quality of life for dengue patients in iquitos, Peru

• Type of Material: Article
• Authors: William H. Elson, University of California Davis; Amy R. Riley-Powell, Tulane University; Amy C. Morrison, University of California Davis; Esther E. Gotlieb, Tulane University; Erik J. Groessl, VA San Diego Healthcare System; Jhonny J. Cordova, University of California Davis; J. Esther Rios, U.S. Naval Medical Research Unit No. 6; W. Lorena Quiroz, U.S. Naval Medical Research Unit No. 6; Alfonso S. Vizcarra, University of California Davis; Robert C. Reiner, University of Washington School of Medicine; Christopher M. Barker, University of California Davis; Gonzalo Vazquez Prokopec, Emory University; Thomas W. Scott, University of California Davis; Alan L. Rothman, University of Rhode Island Feinstein Providence Campus; John P. Elder, San Diego State University; Valerie A. Paz-Soldan, Tulane University
• Language: English
• Date: 2020-07-01
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: ACM, WLQ and JER is/were employees of the United States government. This work was prepared as part of their official duties. Title 17 U.S.C. 105 provides that `copyright protection under this title is not available for any work of the United States Government.' Title 17 U.S.C. 101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person's official duties.
• License: Creative Commons Universal : Public Domain Dedication
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pntd.0008477
• Title of Journal or Parent Work: PLoS Neglected Tropical Diseases
• Volume: 14
• Issue: 7
• Start Page: 1
• End Page: 17
• Grant/Funding Information: ARP was supported by the Wellcome Trust (212712/Z/18/Z).; Further support was provided by the Military Infectious Disease Research Program award number S0520_15_LI and the US Department of Defense Global Emerging Infections Systems Research Program Work Unit No. 847705.82000.25GB.B0016.; This research was supported by grant number P01AI098670 from the National Institutes of Health, National Institute of Allergy and Infectious Diseases (https://www.niaid.nih.gov) (TWS PI).
• Keywords: Adult; Humans; Quality of Life; Male; Young Adult; Peru; Dengue; Female; Adolescent
• Research Categories: Biology, Entomology; Biology, Microbiology; Health Sciences, Immunology; Health Sciences, Public Health

Abstract

Previous studies measuring the health-related quality of life (HRQoL) of individuals with dengue focused on treatment seeking populations. However, the vast majority of global dengue cases are unlikely to be detected by health systems. Representative measurements of HRQoL should therefore include patients with disease not likely to trigger treatment-seeking behavior. This study based in Iquitos, Peru used the Quality of Wellbeing Scale-Self Administered, a survey that enquires about not only physical health, but also psychological health, self-care, mobility, and usual social activities, and rates HRQoL between 0 (death) and 1 (optimum function), to evaluate the impact of dengue on HRQoL. In order to enroll treatment and non treatment-seeking participants, three modalities of participant recruitment were used. In addition to clinic and community-based febrile surveillance, a contact-cluster methodology was also employed to identify infected individuals less likely to seek treatment. We measured changes in HRQoL and identified common areas of health impairment in 73 virologically confirmed dengue cases at 3 time points during the participant’s illness; the earlyacute (days 0–6 post symptom onset), late-acute (days 7–20), and convalescent illness phases (days 21 +). Participants reported HRQoL related impairments at significantly higher frequency during the early-acute versus convalescent illness phase (Fisher’s exact: P<0.01). There was substantial heterogeneity in scores during each illness phase with median scores in the early-acute, late-acute and convalescent phases of 0.56 (IQR: 0.41– 0.64), 0.70 (IQR: 0.57–0.94), and 1 (IQR: 0.80–1.00), respectively. In all illness phases participants recruited in clinics had on average the lowest HRQoL scores where as those recruited in the contact clusters had the highest. Only 1 individual who was recruited in the contact-clusters had no reduction in HRQoL score during their illness. These data illustrate that dengue should be considered as a disease that may have significant implications for not only physical health but also psychological health and social functioning. The impact of dengue on the HRQoL of non-treatment-seeking individuals, although lower than the impact among treatment-seeking individuals, is not necessarily trivial.