Dados do Trabalho

Título

Impact of cutaneous leishmaniasis on the quality of life of the Brazilian patients using EQ-5D-3L instrument

Introdução

Cutaneous leishmaniasis (CL) is one of the most prevalent neglected tropical diseases that affect the skin, presenting as ulcers (single or multiple), often related to disfiguring scars, stigmatization and sometimes, mucosal involvement.

Objetivo (s)

To evaluate the impact of Cutaneous leishmaniasis (CL) on the Brazilian patient’s health related quality of life (HRQoL) using EQ-5D-3L/VAS questionnaire.

Material e Métodos

Cross-sectional study to evaluate the HRQoL of CL patients diagnosed in a public health center for leishmaniasis in Brazil. The interviews were conducted using the EQ-5D-3L instrument. Patients were asked to evaluate their current and retrospective (before the CL symptoms) health state and to provide some sociodemographic information. HRQOL losses were estimated using the societal value sets previously estimated for Minas Gerais (Brazil) population in 2011. Difference between the current and retrospective health status was evaluated by using Stuart-Maxwell test for marginal homogeneity for categorical variables and Wilcoxon test for continuous variables (significance level set at 5%). All the analyses were performed using the SPSS program (v. 22).

Resultados e Conclusão

A total of 88 patients were interviewed between October 2020 and June 2022; 82% had solely cutaneous and 18% had mucosal involvement. The median age was 56 years, and 74% of the participants were men. In general, patients reported better health conditions before the disease onset, indicating HRQoL loss related to CL. Significant harmful effect attributed to CL was detected in all life dimensions evaluated. The estimated mean utility was 0.898 and 0.783, respectively before and after illness onset. This observation is consistent with the patient's self-reported general health state expressed by visual analogue scale (VAS). The health status was considered regular, bad, and very bad before CL onset by 17% of patients in contrast with 44.3% after CL onset (p<0.001) according to VAS score, confirming the HRQOL losses. The average score before the CL symptoms (86.6) is similar to the one observed for the Minas Gerais population, 83.8. After the onset of the disease symptoms, the VAS score decreased to 69.4. Our results confirm that CL strongly affects the patients' HRQoL and indicate the usefulness of the EQ-5D-3L. This study represents an attempt to measure the burden of disease and in the future, it may contribute to the comparison of the impact of different interventions for leishmaniasis.

Palavras-chave

Leishmaniasis; Cutaneous; Quality of Life