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Patients with life-threatening illnesses in intensive care receive management that improves their chances for survival. The physical outcomes of individuals infected with HIV who survive an intensive care unit (ICU) stay are not well known. The purpose was to describe the physical outcomes of ICU survivors in a high HIV prevalent area and highlight challenges as it relates to study feasibility. A pilot study at a tertiary-care university-affiliated hospital was done. Participants were assessed at ICU and ward admission, hospital discharge, three and six months following discharge. The profile and physical function, assessed with the ICU Mobility Scale, Karnofsky Performance Status Scale and six-minute walk test, of participants was determined. The EQ-5D-3 L provides information on participants' health-related quality of life (HRQOL). The pilot study consists of five patients (n = 173 screened). All were independently mobile and on antiretroviral therapy prior to hospital admission. Respiratory and peripheral muscle weakness were present with variable performance in physical function across participants. Improvement in function occurred over time but participants still had physical dysfunction at six months. Pain/physical discomfort and anxiety/depression were common complaints influencing HRQOL. ICU survivors, who are HIV-positive, present with significant physical dysfunction who require rehabilitation to reduce disability.

Background: Adverse events (AEs) are common during treatment of drug-resistant tuberculosis (DR-TB). Little is known about the health-related quality of life (HRQoL) of patients receiving treatment for DR-TB or the effect of AEs on HRQoL., Methods: We conducted a cross-sectional study among adult patients with laboratory-confirmed rifampicin resistant tuberculosis (TB) on DR-TB treatment at a public-sector outpatient DR-TB clinic in Johannesburg, South Africa between 02/2015-01/2018. Data on HRQoL using the Medical Outcomes Short Form-36 (SF-36) questionnaire and self-reported AEs were collected by trained interviewers through face-to-face interviews. We report averages for the eight major domains and mental (MCS) and physical health (PCS) component summary scores, stratified by whether AEs were reported in the last four weeks. For comparative purposes, we enrolled two other patient groups and included data on a separate group of healthy adults., Results: We enrolled 149 DR-TB patients (median age 36 years IQR 29-43, 55% male, 77.9% HIV-positive, 81% on ART, 61.8% on a standard long-course regimen and 44.3% on DR-TB treatment for less than 6 months). 58/149 (38.9%) patients reported a total of 122 AEs in the preceding 4 weeks, of these the most common were joint pain (n = 22), peripheral neuropathy (n = 16), hearing loss (n = 15), nausea and vomiting (n = 12) and dizziness or vertigo (n = 11). SF-36 domains and summary scores (MCS and PCS) were lower in those who reported an AE compared to those who did not, and both were lower than healthy adults. Compared to those who did not report an AE, patients who reported AEs were more likely to have a low MCS (aRR 2.24 95% CI 1.53-3.27) and PCS (aRR 1.52 95% CI 1.07-2.18) summary score. HRQoL was lower among those on DR-TB treatment for 6 months or less., Conclusion: Results show that DR-TB had a substantial impact on patients' quality of life, but that AEs during the early months on treatment may be responsible for reducing HRQoL even further. Our findings highlight the negative effects of injectable agents on HRQoL. Patients require an integrative patient-centered approach to deal with DR-TB and HIV and the potential overlapping toxicities which may be worsened by concurrent treatment.

Objective: To determine the effect of a workplace intervention programme on the rate of return to work of previously employed stroke survivors in the Gauteng province of South Africa., Design: A randomised controlled trial., Setting: Participants' workplaces and three hospitals with stroke rehabilitation facilities., Subjects: Eighty stroke survivors between the ages of 18 and 60 years who were employed at the time of stroke onset., Intervention: The workplace intervention programme was tailored according to functional ability and workplace challenges of each stroke survivor. The control group received usual stroke care which took into consideration job requirements but without workplace intervention., Main Outcomes: The primary outcome was return to work rate. Secondary outcomes included activities of daily living (ADLs), mobility, basic cognitive function and perceived quality of life., Results: At six months follow-up 60% (n = 24) of stroke survivors in the intervention group returned to work compared to 20% (n = 8) in the control group (P <0.001). The odds ratio for return to work for stroke survivors in the intervention group was 5.2. For every unit increase in the ADLs and cognitive assessment score, the odds of return to work increased by 1.7 and 1.3 respectively; those who returned to work had better quality of life than those who did not return to work (P = 0.05)., Conclusion: A workplace intervention consisting of workability assessments and workplace visits was effective in facilitating return to work for stroke survivors in the Gauteng province of South Africa., (© The Author(s) 2014.)

Purpose: To study how the health-related quality of life (HRQOL) of survivors of penetrating trunk trauma (PTT) changes from pre-morbid status to 6 months after hospital discharge and to determine differences in the HRQOL between subjects ventilated for short and prolonged periods of time. To determine how the HRQOL of PTT survivors compares with that of a healthy control group in order to identify limitations imposed by critical illness. Methods: Retrospective and observational prospective assessment of the quality of life (QoL) of PTT survivors with the Medical Outcomes Short Form-36 (SF-36) UK English version questionnaire. Cross-sectional assessment of the QoL of a healthy control group with the SF-36. Results: The physical component summary (PCS) score was significantly reduced for the short mechanical ventilation (MV) group ( n = 13) at 1 and 3 months compared to pre-admission status ( p = 0.00, respectively). The mental component summary (MCS) score was significantly reduced at 1, 3 and 6 months ( p = 0.00, respectively). The PCS and MCS were significantly reduced for the long MV group ( n = 29) at all three assessments compared to the pre-admission HRQOL ( p = 0.00-0.01). The short MV group reported HRQOL comparable to that of the healthy group ( n = 40) at 6 months after discharge. The long MV group had a significant reduction in the PCS at 1, 3 and 6 months compared to the healthy group ( p = 0.00, respectively). The long MV group had significantly reduced PCS at 3 and 6 months compared to the short MV group ( p = 0.01 and 0.00, respectively). Conclusions: Subjects who had higher morbidity and prolonged MV suffered from reduced HRQOL related to physical health for up to 6 months after discharge. [ABSTRACT FROM AUTHOR]